Depth-dose evaluation for lung and pancreas cancer treatment by BNCT using an epithermal neutron beam

International Nuclear Information System (INIS)

Matsumoto, Tetsuo; Fukushima, Yuji

2000-01-01

The depth-dose distributions were evaluated for possible treatment of both lung and pancreas cancers using an epithermal neutron beam. The MCNP calculations showed that physical dose in tumors were 6 and 7 Gy/h, respectively, for lung and pancreas, attaining an epithermal neutron flux of 5x10 8 ncm -2 s -1 . The boron concentrations were assumed at 100 ppm and 30 ppm, respectively, for lung and pancreas tumors and normal tissues contains 1/10 tumor concentrations. The dose ratios of tumor to normal tissue were 2.5 and 2.4, respectively, for lung and pancreas. The dose evaluation suggests that BNCT could be applied for both lung and pancreas cancer treatment. (author)

Case Study: Pancreas cancer with Whipple's operation | Blaauw ...

African Journals Online (AJOL)

The following case study was discussed at the SASPEN Workshop held during the Nutrition Congress 2014. It is a reflection of the general opinion of the audience, followed by a rationale of the latest literature on the topic. Herewith follows a summarised discussion of the case. Keywords: pancreas cancer, Whipple ...

Resection for secondary malignancy of the pancreas.

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Hung, Jui-Hsia; Wang, Shin-E; Shyr, Yi-Ming; Su, Cheng-Hsi; Chen, Tien-Hua; Wu, Chew-Wun

2012-01-01

This study tried to clarify the role of pancreatic resection in the treatment of secondary malignancy with metastasis or local invasion to the pancreas in terms of surgical risk and survival benefit. Data of secondary malignancy of the pancreas from our 19 patients and cases reported in the English literature were pooled together for analysis. There were 329 cases of resected secondary malignancy of the pancreas, including 241 cases of metastasis and 88 cases of local invasion. The most common primary tumor metastatic to the pancreas and amenable to resection was renal cell carcinoma (RCC) (73.9%). More than half (52.3%) of the primary cancers with local invasion to the pancreas were colon cancer, and nearly half (40.9%) were stomach cancer. The median metastatic interval was 84 months (7 years) for overall primary tumors and 108 months (9 years) for RCC. The 5-year survival for secondary malignancy of the pancreas after resection was 61.1% for metastasis and 58.9% for local invasion, with 72.8% for RCC metastasis, 69.0% for colon cancer, and 43.8% for stomach cancer with local invasion to the pancreas. Pancreatic resection should not be precluded for secondary malignancy of the pancreas because long-term survival could be achieved with acceptable surgical risk in selected patients.

Chemotherapy and intensity modulated conformational radiotherapy for locally advanced pancreas cancers

International Nuclear Information System (INIS)

Huguet, F.; Wu, A.; Zhang, Z.; Winston, C.; Reidy, D.; Ho, A.; Allen, P.; Karyn, G.

2011-01-01

The authors report a retrospective study of the tolerance and survival of 48 patients who have been treated by a chemotherapy followed by a chemotherapy concomitant with an intensity-modulated radiotherapy for a locally advanced pancreas cancer. Results are discussed in terms of toxicity, cancer response, operability, survival rate. Tolerance is good. Local control rates, global survival rates and secondary resection rates are promising. Short communication

Chemotherapy and intensity modulated conformational radiotherapy for locally advanced pancreas cancers; Chimiotherapie et radiotherapie conformationnelle avec modulation d'intensite pour les cancers du pancreas localement evolues

Energy Technology Data Exchange (ETDEWEB)

Huguet, F. [Hopital Tenon, Paris (France); Wu, A.; Zhang, Z.; Winston, C.; Reidy, D.; Ho, A.; Allen, P.; Karyn, G. [Memorial Sloan-Kettering Cancer Center, New York (United States)

2011-10-15

The authors report a retrospective study of the tolerance and survival of 48 patients who have been treated by a chemotherapy followed by a chemotherapy concomitant with an intensity-modulated radiotherapy for a locally advanced pancreas cancer. Results are discussed in terms of toxicity, cancer response, operability, survival rate. Tolerance is good. Local control rates, global survival rates and secondary resection rates are promising. Short communication

Role of endoscopic ultrasonography in evaluation of metastatic lesions to the pancreas: a tertiary cancer center experience.

Science.gov (United States)

Atiq, Muslim; Bhutani, Manoop S; Ross, William A; Raju, Gottumukkala S; Gong, Yun; Tamm, Eric P; Javle, Milind; Wang, Xuemei; Lee, Jeffrey H

2013-04-01

Metastatic lesions to the pancreas pose diagnostic challenges with regards to their differentiation from primary pancreatic cancer. Data on the yield of endoscopic ultrasonography (EUS)-guided fine-needle aspiration in detection of these lesions are limited. This is a retrospective review of 23 patients referred to a tertiary referral center for further evaluation of suspected pancreatic metastases. Main outcome measures were diagnostic yield of endoscopic ultrasonography-guided fine-needle aspiration in evaluation of metastatic lesions to the pancreas. Of 644 patients, 23 (3.6%) undergoing EUS of the pancreas were diagnosed to have metastatic disease to the pancreas based on clinical, radiological, and cytological results. Mean (SD) age was 64.3 (11.7) years. Of the 23 patients, 18 (78.3%) were asymptomatic. Mean (SD) size of lesion on EUS was 39.1 (19.9) mm. A diagnosis of malignant lesion was made in 21 of 23 cases, with a diagnostic accuracy of 91.3%. Metastatic lesions to the pancreas present as incidental, solitary mass lesions on staging or surveillance imaging. Endoscopic ultrasonography-guided fine-needle aspiration is an important tool in the characterization and further differentiation of metastatic lesions to the pancreas from primary pancreatic cancer.

Biomarker validation for intraductal papillary mucinous neoplasms of the pancreas | Division of Cancer Prevention

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A critical component to successful cancer screening is the identification of a lesion for which intervention will result in prolonged survival or cure.The five-year survival of patients with resected stage IA pancreas cancer (the earliest identifiable lesion and |

Biobanking of human pancreas cancer tissue: impact of ex-vivo procurement times on RNA quality.

Science.gov (United States)

Rudloff, Udo; Bhanot, Umesh; Gerald, William; Klimstra, David S; Jarnagin, William R; Brennan, Murray F; Allen, Peter J

2010-08-01

Tissue banking has become a major initiative at many oncology centers. The influence of warm ex-vivo ischemia times, storage times, and biobanking protocols on RNA integrity and subsequent microarray data is not well documented. A prospective institutional review board-approved protocol for the banking of abdominal neoplasms was initiated at Memorial Sloan-Kettering Cancer Center in 2001. Sixty-four representative pancreas cancer specimens snap-frozen at various ex-vivo procurement times (1 h) and banked during three time periods (2001-2004, 2004-2006, 2006-2008) were processed. RNA integrity was determined by microcapillary electrophoresis using the RNA integrity number (RIN) algorithm and by results of laser-capture microdissection (LCM). Overall, 42% of human pancreas cancer specimens banked under a dedicated protocol yielded RNA with a RIN of > or =7. Limited warm ex-vivo ischemia times did not negatively impact RNA quality (percentage of tissue with total RNA with RIN of > or =7 for 60 min, 42%), and long-term storage of banked pancreas cancer biospecimens did not negatively influence RNA quality (total RNA with RIN of > or =7 banked 2001-2004, 44%; 2004-2006, 38%; 2006-2008, 50%). RNA retrieved from pancreatic cancer samples with RIN of > or =7 subject to LCM yielded RNA suitable for further downstream applications. Fresh-frozen pancreas tissue banked within a standardized research protocol yields high-quality RNA in approximately 50% of specimens and can be used for enrichment by LCM. Quality of tissues of the biobank were not adversely impacted by limited variations of warm ischemia times or different storage periods. This study shows the challenges and investments required to initiate and maintain high-quality tissue repositories.

De novo malignancy after pancreas transplantation in Japan.

Science.gov (United States)

Tomimaru, Y; Ito, T; Marubashi, S; Kawamoto, K; Tomokuni, A; Asaoka, T; Wada, H; Eguchi, H; Mori, M; Doki, Y; Nagano, H

2015-04-01

Long-term immunosuppression is associated with an increased risk of cancer. Especially, the immunosuppression in pancreas transplantation is more intensive than that in other organ transplantation because of its strong immunogenicity. Therefore, it suggests that the risk of post-transplant de novo malignancy might increase in pancreas transplantation. However, there have been few studies of de novo malignancy after pancreas transplantation. The aim of this study was to analyze the incidence of de novo malignancy after pancreas transplantation in Japan. Post-transplant patients with de novo malignancy were surveyed and characterized in Japan. Among 107 cases receiving pancreas transplantation in Japan between 2001 and 2010, de novo malignancy developed in 9 cases (8.4%): post-transplant lymphoproliferative disorders in 6 cases, colon cancer in 1 case, renal cancer in 1 case, and brain tumor in 1 case. We clarified the incidence of de novo malignancy after pancreas transplantation in Japan. Copyright © 2015 Elsevier Inc. All rights reserved.

Arterioscanning of pancreas

International Nuclear Information System (INIS)

Petrovskij, B.V.; Rabkin, I.Kh.; Matevosov, A.L.

1980-01-01

Investigated is the state of precapillary and capillary net of pancreas vessels by way of intra-arterial MAA 1 +H3+H1I injection. Posiible variants of pancreas form, shape and position, and the main sources of blood supply are presented. The knowledge of the above factors is necessary to avoid mistakes in the desiphering of arterioscannograms. Techniques for angiography and arterioscanning in cases of pancreas cancer, benign tumours, pancreas cyst and chronic pancreatitis are described. Arterioscanning is shown to be a valuable addition to angiography, which permits to judge on the angiographically invisible part of the organ arteriolocapillary channel, clarifying the nature of the process and damage length. The summary estimate of results of angiographic and arterioscannographic investigations considerably increases the diagnostic effectiveness

CT evaluation of gastric cancer. Depth of tumor invasion and pancreas invasion

International Nuclear Information System (INIS)

Banba, Yoshihisa; Kanazawa, Tadayoshi; Seto, Hikaru

1998-01-01

To compare the internal structure of tumor and the contiguous organ configuration on computed tomography (CT) with the depth of tumor invasion on the pathological specimen. Sixty-four gastric cancers depicted on incremental dynamic CT were classified according to the internal structure of the tumor, and correlated with the depth of tumor invasion. In addition, the cancers were classified according to the contiguous pancreatic configuration, and correlated with the degree of pancreatic invasion. Eleven tumors with thickened gastric wall consisting of both a thick inner layer of high attenuation and a thin outer layer of low attenuation (two-layered tumor with a thin outer layer) did not invade the serosa: mucosa (n=5) and submucosa (n=6). Of 59 gastric cancers with a regular margin to the contiguous pancreas, pancreatic invasion was absent in 58 and present in one. Pancreatic invasion was present in all of five gastric cancers with an irregular margin. Our results indicate that two-layered gastric tumors with a thin outer layer never invade the serosa. Furthermore, pancreatic invasion is predicted only when the margin of the contiguous pancreas is irregular. (author)

Multimodal treatment utilizing intraoperative radiotherapy for advanced cancer of the pancreas

International Nuclear Information System (INIS)

Onodera, Tokio

1982-01-01

A multimodal treatment was consisted of intraoperative radiation, external radiation, by-pass operation, chemotherapy and total parenteral nutrition if necessary to cover decreased oral-intake. Thirty-three cases were subjected to this therapy for 6 years. The stage of the tumors varied from a localized tumor in the pancreas to a huge tumor with multiple metastases, though the latter abandoned recently to be contraindication to this therapy. At laparotomy, a high energy electron beam was irradiated to the tumor with a dosage of 3,000 rad using a 20 MeV Betatron. The tumor was carefully prepared in order to avoid irradiating the duodenum and stomach. Choledochojejunostomy and gastrojejunostomy were performed in almost all of patients with cancer of head of pancreas. In some patients, external radiation was added with a dosage of 3,000 rad by linear X-ray. After radiotherapy, chemotherapy employing 5-FU or FT-207 was continued including. The survival time after this therapy was varied mainly according to the stages of the tumor. In patients with multiple metastasis to the liver or peritoneal dissemination, no remarkable effects were obtained by this therapy. On the otherhand, among 14 patients with localized tumor in the pancreas, 7 survived more than one year and the mean survival time of treated patients was nevershorter than that of patients who received resection of the tumor. Most of the treated patients could spend at home until their condition became critical, because by-pass operation could overcome jaundice or the duodenal stenosis and intraoperative radiation could palliate the pain of cancer of pancreas. Tumor effect of intraoperative radiation was confirmed by both of the second laporatomy for twice intraoperative radiation and laparatomy. (author)

Completion pancreatectomy for recurrent pancreatic cancer in the remnant pancreas: report of six cases and a review of the literature.

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Shima, Yasuo; Okabayashi, Takehiro; Kozuki, Akihito; Sumiyoshi, Tatsuaki; Tokumaru, Teppei; Saisaka, Yuichi; Date, Keiichi; Iwata, Jun

2015-12-01

There are no accepted surgical strategies for the treatment of pancreatic cancer recurrence in the remnant pancreas after initial resection. We retrospectively analyzed our experiences with patients undergoing completion pancreatectomy for recurrent pancreatic cancer in the remnant pancreas. Six patients with recurrent pancreatic cancer in the remnant pancreas underwent completion pancreatectomy between March 2005 and December 2012. Operative, postoperative, and pathological data and long-term outcomes for these six patients were analyzed retrospectively. There was no operative morbidity or mortality associated with completion pancreatectomy. The median survival times were 49.0 and 27.5 months after initial resection and second pancreatectomy, respectively. However, all six patients died during follow-up. Five patients had recurrent pancreatic cancer at the time of death. One patient had no recurrence but had poor blood sugar control and eventually died after repeated bouts of cholangitis. Completion pancreatectomy is a safe and effective option in select patients with local pancreatic cancer recurrence in the remnant pancreas after initial pancreatectomy. It is essential to select patients who have a good performance status and can tolerate major surgery and the resultant apancreatic state.

Spatiotemporal proteomic analyses during pancreas cancer progression identifies serine/threonine stress kinase 4 (STK4) as a novel candidate biomarker for early stage disease.

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Mirus, Justin E; Zhang, Yuzheng; Hollingsworth, Michael A; Solan, Joell L; Lampe, Paul D; Hingorani, Sunil R

2014-12-01

Pancreas cancer, or pancreatic ductal adenocarcinoma, is the deadliest of solid tumors, with a five-year survival rate of pancreas cancer. Mouse models that accurately recapitulate the human condition allow disease tracking from inception to invasion and can therefore be useful for studying early disease stages in which surgical resection is possible. Using a highly faithful mouse model of pancreas cancer in conjunction with a high-density antibody microarray containing ∼2500 antibodies, we interrogated the pancreatic tissue proteome at preinvasive and invasive stages of disease. The goal was to discover early stage tissue markers of pancreas cancer and follow them through histologically defined stages of disease using cohorts of mice lacking overt clinical signs and symptoms and those with end-stage metastatic disease, respectively. A panel of seven up-regulated proteins distinguishing pancreas cancer from normal pancreas was validated, and their levels were assessed in tissues collected at preinvasive, early invasive, and moribund stages of disease. Six of the seven markers also differentiated pancreas cancer from an experimental model of chronic pancreatitis. The levels of serine/threonine stress kinase 4 (STK4) increased between preinvasive and invasive stages, suggesting its potential as a tissue biomarker, and perhaps its involvement in progression from precursor pancreatic intraepithelial neoplasia to pancreatic ductal adenocarcinoma. Immunohistochemistry of STK4 at different stages of disease revealed a dynamic expression pattern further implicating it in early tumorigenic events. Immunohistochemistry of a panel of human pancreas cancers confirmed that STK4 levels were increased in tumor epithelia relative to normal tissue. Overall, this integrated approach yielded several tissue markers that could serve as signatures of disease stage, including early (resectable), and therefore clinically meaningful, stages. © 2014 by The American Society for

Assessment of the diagnostic value of combined determination of serum CA199 CA125 and CEA in patients with cancer of pancreas

International Nuclear Information System (INIS)

Wu Congshan; Liu Xugui

2005-01-01

Objective: To assess the diagnostic value of combined determination of serum CA199, CA125 and CEA for cancer of pancreas. Methods: Serum CA199, CA125 and CEA levels were detected with CLIA in 32 patients with cancer of pancreas and 36 controls. Results: Positive detection rate of CA199 in patients with cancer of pancreas was 90.6% (29/32). Positive rate for CA125 and CEA was 65.6% (21/32) and 46.9% (15/32) respectively. With combined determination of these 3 tumor markers, the positive rate was 96.9% (31/32). The mean content of serum CA199 after successful operation (32.5±8.4U/ml) was significantly lower than that before operation (840.2 ± 102.5U/ml) (P<0.01). Conclusion: Combined determination of CA199, CA125 and CEA would improve the detection rate of cancer of pancreas and post-operative changes of CA199 could be of prognostic value. (authors)

Pancreatic Metastasis of High-Grade Papillary Serous Ovarian Carcinoma Mimicking Primary Pancreas Cancer: A Case Report

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Yusuf Gunay

2012-01-01

Full Text Available Introduction. Reports of epithelial ovarian carcinomas metastatic to the pancreas are very rare. We herein present a metastasis of high grade papillary serous ovarian cancer to mid portion of pancreas. Case. A 42-year-old patient was admitted with a non-specified malignant cystic lesion in midportion of pancreas. She had a history of surgical treatment for papillary serous ovarian adenocarcinoma. A cystic lesion was revealed by an abdominal computerized tomography (CT performed in her follow up . It was considered as primary mid portion of pancreatic cancer and a distal pancreatectomy was performed. The final pathology showed high-grade papillary serous adenocarcinoma morphologically similar to the previously diagnosed ovarian cancer. Discussion. Metastatic pancreatic cancers should be considered in patients who present with a solitary pancreatic mass and had a previous non-pancreatic malignancy. Differential diagnosis of primary pancreatic neoplasm from metastatic malignancy may be very difficult. A biopsy for tissue confirmation is required to differentiate primary and secondary pancreatic tumors. Although, the value of surgical resection is poorly documented, resection may be considered in selected patients. Conclusion. Pancreatic metastasis of ovarian papillary serous adenocarcinoma has to be kept in mind when a patient with pancreatic mass has a history of ovarian malignancy.

Pancreas and cyst segmentation

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Dmitriev, Konstantin; Gutenko, Ievgeniia; Nadeem, Saad; Kaufman, Arie

2016-03-01

Accurate segmentation of abdominal organs from medical images is an essential part of surgical planning and computer-aided disease diagnosis. Many existing algorithms are specialized for the segmentation of healthy organs. Cystic pancreas segmentation is especially challenging due to its low contrast boundaries, variability in shape, location and the stage of the pancreatic cancer. We present a semi-automatic segmentation algorithm for pancreata with cysts. In contrast to existing automatic segmentation approaches for healthy pancreas segmentation which are amenable to atlas/statistical shape approaches, a pancreas with cysts can have even higher variability with respect to the shape of the pancreas due to the size and shape of the cyst(s). Hence, fine results are better attained with semi-automatic steerable approaches. We use a novel combination of random walker and region growing approaches to delineate the boundaries of the pancreas and cysts with respective best Dice coefficients of 85.1% and 86.7%, and respective best volumetric overlap errors of 26.0% and 23.5%. Results show that the proposed algorithm for pancreas and pancreatic cyst segmentation is accurate and stable.

TOP1 gene copy numbers are increased in cancers of the bile duct and pancreas

DEFF Research Database (Denmark)

Grunnet, Mie; Calatayud, Dan; Schultz, Nicolai Aa.

2015-01-01

) poison. Top1 protein, TOP1 gene copy number and mRNA expression, respectively, have been proposed as predictive biomarkers of response to irinotecan in other cancers. Here we investigate the occurrence of TOP1 gene aberrations in cancers of the bile ducts and pancreas. Material and methods. TOP1...

Successful resection of pancreatic head cancer in a patient with circumportal pancreas: a case report with technical consideration

Directory of Open Access Journals (Sweden)

Kawamoto Hiroshi

2017-03-01

Full Text Available We report a case of pancreaticoduodenectomy for pancreatic head cancer with circumportal pancreas (CP. A 76-year-old woman was referred to our hospital with complaint of generalized pruritus. Dynamic computed tomography (CT revealed an unenhanced mass at the head of the pancreas and a dilated main pancreatic duct (MPD behind the superior mesenteric vein (SMV. She was diagnosed with pancreatic head cancer with CP and underwent subtotal stomach-preserving pancreaticoduodenectomy (SSpPD. The pancreas was transected both beneath and above the SMV, and the dominant dorsal edge of the pancreas was mobilized and anastomosed with the gut, whereas the ventral edge was closed by suture and attached to the gut. The postoperative course was uneventful without the occurrence of pancreatic fistula or bleeding. CP is a rare anomaly in which a portal vein (PV is encircled by the annular pancreatic parenchyma. CP is usually asymptomatic without any significant comorbidity but may become a surgical hazard when pancreaticoduodenectomy is performed. We report our successfully treated case, with special references to the technical approach for pancreatic anastomosis.

Biomarker-driven trial in metastatic pancreas cancer: feasibility in a multicenter study of saracatinib, an oral Src inhibitor, in previously treated pancreatic cancer

International Nuclear Information System (INIS)

Arcaroli, John; Quackenbush, Kevin; Dasari, Arvind; Powell, Rebecca; McManus, Martine; Tan, Aik-Choon; Foster, Nathan R; Picus, Joel; Wright, John; Nallapareddy, Sujatha; Erlichman, Charles; Hidalgo, Manuel; Messersmith, Wells A

2012-01-01

Src tyrosine kinases are overexpressed in pancreatic cancers, and the oral Src inhibitor saracatinib has shown antitumor activity in preclinical models of pancreas cancer. We performed a CTEP-sponsored Phase II clinical trial of saracatinib in previously treated pancreas cancer patients, with a primary endpoint of 6-month survival. A Simon MinMax two-stage phase II design was used. Saracatinib (175 mg/day) was administered orally continuously in 28-day cycles. In the unselected portion of the study, 18 patients were evaluable. Only two (11%) patients survived for at least 6 months, and three 6-month survivors were required to move to second stage of study as originally designed. The study was amended as a biomarker-driven trial (leucine rich repeat containing protein 19 [LRRC19] > insulin-like growth factor-binding protein 2 [IGFBP2] “top scoring pairs” polymerase chain reaction [PCR] assay, and PIK3CA mutant) based on preclinical data in a human pancreas tumor explant model. In the biomarker study, archival tumor tissue or fresh tumor biopsies were tested. Biomarker-positive patients were eligible for the study. Only one patient was PIK3CA mutant in a 3′ untranslated region (UTR) portion of the gene. This patient was enrolled in the study and failed to meet the 6-month survival endpoint. As the frequency of biomarker-positive patients was very low (<3%), the study was closed. Although we were unable to conclude whether enriching for a subset of second/third line pancreatic cancer patients treated with a Src inhibitor based on a biomarker would improve 6-month survival, we demonstrate that testing pancreatic tumor samples for a biomarker-driven, multicenter study in metastatic pancreas cancer is feasible

Radiotherapy for cancer of the pancreas

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Manabe, Tadao; Tobe, Takakichi; Abe, Mitsuyuki; Takahashi, Masaharu; Shibamoto, Yuta

1984-11-01

Twelve patiens with cancer of the pancreas underwent intraoperative radiation (n=5) or external radiation (n=7) therapy. Of the five patients with intraoperative radiotheray, three patients who had pancreatectomy received a dose of 2,500--3,000 rad on the 6--10 MeV Betatron. One patient developed radiation pancreatitis and died 0.7 month after the surgery. One died of hepatic metastasis 8.5 months after the surgery, however, recurrence was not found in the radiation field. The other one is alive for 1.5 months after the surgery. For two patients with unresectable cancer, a dose of 2,500--3,000 rad using 13--16 MeV Betatron was irradiated intraoperatively. These two patients are alive for 0.5 and 1.0 months after the surgery. Seven patients were treated with external beam radiation with a dose of 2,800--5,000 rad using 10 MeV lineac x-ray. Of two patients with pancreatectomy, one died of recurrent disease 13.4 months after the surgery and one is alive for 9.5 months after the surgery. In five patients with distant metastases to the liver, lung or peritoneal dissemination, external beam irradiation did not produce any prolongation of their survivals, however, remarkable effects on performance status were obtained (J.P.N.).

Radiotherapy for cancer of the pancreas

International Nuclear Information System (INIS)

Manabe, Tadao; Tobe, Takakichi; Abe, Mitsuyuki; Takahashi, Masaharu; Shibamoto, Yuta

1984-01-01

Twelve patiens with cancer of the pancreas underwent intraoperative radiation (n=5) or external radiation (n=7) therapy. Of the five patients with intraoperative radiotheray, three patients who had pancreatectomy received a dose of 2,500--3,000 rad on the 6--10 MeV Betatron. One patient developed radiation pancreatitis and died 0.7 month after the surgery. One died of hepatic metastasis 8.5 months after the surgery, however, recurrence was not found in the radiation field. The other one is alive for 1.5 months after the surgery. For two patients with unresectable cancer, a dose of 2,500--3,000 rad using 13--16 MeV Betatron was irradiated intraoperatively. These two patients are alive for 0.5 and 1.0 months after the surgery. Seven patients were treated with external beam radiation with a dose of 2,800--5,000 rad using 10 MeV lineac x-ray. Of two patients with pancreatectomy, one died of recurrent disease 13.4 months after the surgery and one is alive for 9.5 months after the surgery. In five patients with distant metastases to the liver, lung or peritoneal dissemination, external beam irradiation did not produce any prolongation of their survivals, however, remarkable effects on performance status were obtained (J.P.N.)

Human pancreas scintigraphy using iodine-123-labeled HIPDM and SPECT

International Nuclear Information System (INIS)

Yamamoto, K.; Shibata, T.; Saji, H.; Kubo, S.; Aoki, E.; Fujita, T.; Yonekura, Y.; Konishi, J.; Yokoyama, A.

1990-01-01

The pancreatic affinity of iodine-123-labeled HIPDM (N,N,N'-trimethyl-N'-(2-hydroxy-3-methyl-5-iodobenzyl)-1,3-propane diamine) ([ 123 I]HIPDM) was studied in 18 cases (5 normal volunteers, 7 cases with pancreas cancer, and 6 with chronic pancreatitis). In the normal cases, the pancreas was visualized in the planar images as early as 3 hr, and again at 20 hr postinjection. Single-photon emission computed tomography (SPECT) performed following 3-hr planar scintigraphy, provided excellent pancreas images without an overlap of activity in the liver or spleen. The mean pancreas-to-liver (P/L) ratio was 1.26 +/- 0.22 in normal controls. With the exception of one case of massive calcification in the pancreas, the entire pancreas could be observed in the cases with chronic pancreatitis, but the P/L ratio was 0.74 +/- 0.15, significantly lower than that of normal cases. Defective areas of the distal portion of the pancreas were clearly seen in those with cancer of the pancreas. The results of our study indicate that [ 123 I] HIPDM may have clinical potential as a human pancreas imaging agent

Cellular and molecular mechanisms coordinating pancreas development.

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Bastidas-Ponce, Aimée; Scheibner, Katharina; Lickert, Heiko; Bakhti, Mostafa

2017-08-15

The pancreas is an endoderm-derived glandular organ that participates in the regulation of systemic glucose metabolism and food digestion through the function of its endocrine and exocrine compartments, respectively. While intensive research has explored the signaling pathways and transcriptional programs that govern pancreas development, much remains to be discovered regarding the cellular processes that orchestrate pancreas morphogenesis. Here, we discuss the developmental mechanisms and principles that are known to underlie pancreas development, from induction and lineage formation to morphogenesis and organogenesis. Elucidating such principles will help to identify novel candidate disease genes and unravel the pathogenesis of pancreas-related diseases, such as diabetes, pancreatitis and cancer. © 2017. Published by The Company of Biologists Ltd.

Minimally Invasive Management of Ectopic Pancreas.

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Vitiello, Gerardo A; Cavnar, Michael J; Hajdu, Cristina; Khaykis, Inessa; Newman, Elliot; Melis, Marcovalerio; Pachter, H Leon; Cohen, Steven M

2017-03-01

The management of ectopic pancreas is not well defined. This study aims to determine the prevalence of symptomatic ectopic pancreas and identify those who may benefit from treatment, with a particular focus on robotically assisted surgical management. Our institutional pathology database was queried to identify a cohort of ectopic pancreas specimens. Additional clinical data regarding clinical symptomatology, diagnostic studies, and treatment were obtained through chart review. Nineteen cases of ectopic pancreas were found incidentally during surgery for another condition or found incidentally in a pathologic specimen (65.5%). Eleven patients (37.9%) reported prior symptoms, notably abdominal pain and/or gastrointestinal bleeding. The most common locations for ectopic pancreas were the duodenum and small bowel (31% and 27.6%, respectively). Three out of 29 cases (10.3%) had no symptoms, but had evidence of preneoplastic changes on pathology, while one harbored pancreatic cancer. Over the years, treatment of ectopic pancreas has shifted from open to laparoscopic and more recently to robotic surgery. Our experience is in line with existing evidence supporting surgical treatment of symptomatic or complicated ectopic pancreas. In the current era, minimally invasive and robotic surgery can be used safely and successfully for treatment of ectopic pancreas.

Pancreas

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... Page Transplant Living > Organ facts and surgeries > Pancreas Pancreas Beneath your ribs, you’ll find the pancreas, ... shape. Location of the pancreas How does the pancreas work? The pancreas controls your sugar levels and ...

Peroperative radiotherapy in the treatment of cancer of the pancreas

International Nuclear Information System (INIS)

Huguier, M.; Schlienger, M.; Houry, S.; Charron, R.

1987-01-01

7 patients presenting with unresected (6 cases) or resected (1 case) cancer of the pancreas were treated peroperatively by radiotherapy. Tumors were treated with 15 to 20 Gy delivered by a particle accelerator. There were no post-operative complications. Three patients who were experiencing pain before radiotherapy no longer had pain after radiotherapy and this effect was maintained. Five patients died during the follow-up period after 5 to 10 months. Two patients are still alive after 4 and 9 months follow-up. This experience with peroperative radiotherapy should be continued [fr

Dissection of the Mouse Pancreas for Histological Analysis and Metabolic Profiling.

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Veite-Schmahl, Michelle J; Regan, Daniel P; Rivers, Adam C; Nowatzke, Joseph F; Kennedy, Michael A

2017-08-19

We have been investigating the pancreas specific transcription factor, 1a cre-recombinase; lox-stop-lox- Kristen rat sarcoma, glycine to aspartic acid at the 12 codon (Ptf1a cre/+ ;LSL-Kras G12D/+ ) mouse strain as a model of human pancreatic cancer. The goal of our current studies is to identify novel metabolic biomarkers of pancreatic cancer progression. We have performed metabolic profiling of urine, feces, blood, and pancreas tissue extracts, as well as histological analyses of the pancreas to stage the cancer progression. The mouse pancreas is not a well-defined solid organ like in humans, but rather is a diffusely distributed soft tissue that is not easily identified by individuals unfamiliar with mouse internal anatomy or by individuals that have little or no experience performing mouse organ dissections. The purpose of this article is to provide a detailed step-wise visual demonstration to guide novices in the removal of the mouse pancreas by dissection. This article should be especially valuable to students and investigators new to research that requires harvesting of the mouse pancreas by dissection for metabolic profiling or histological analyses.

Potential use of point shear wave elastography for the pancreas: A single center prospective study

International Nuclear Information System (INIS)

Kawada, Natsuko; Tanaka, Sachiko; Uehara, Hiroyuki; Ohkawa, Kazuyoshi; Yamai, Takuo; Takada, Ryoji; Shiroeda, Hisakazu; Arisawa, Tomiyasu; Tomita, Yasuhiko

2014-01-01

Aim: Clinical use of point shear wave elastography for the liver has been established, however, few studies demonstrated its usefulness for the pancreas. A prospective study was conducted to clarify its feasibility for the pancreas and its usefulness for the identification of high risk group for pancreatic cancer. Patients and methods: Consecutive eighty-five patients underwent point shear wave elastography for the pancreas. The success rate of shear wave velocity (SWV) measurement, that is the number of successful measurements over total 10 measurements, was recorded. The SWV of the pancreas measured at non-tumorous area was compared between patients with and without pancreatic cancer. Factors associated with high SWV were determined by logistic regression model. Results: Sixty patients were included, of these 18 had pancreatic cancer. The success rate of 100% was achieved at the head, the body and the tail of the pancreas in 80%, 83%, and 68% of the patients, respectively. The success rate of ≥80% was achieved in 100%, 100%, and 96% of the patients, respectively. Although mean SWV of the pancreas harboring pancreatic cancer tended to be higher compared with that of the pancreas without cancer (1.51 ± 0.45 m/s vs 1.43 ± 0.28 m/s), they did not reach statistical significance. Multivariate analysis showed that increased amount of alcohol intake was associated with high SWV. Conclusion: The SWV of the pancreas was measured with excellent success rate. However, tendency of higher SWV obtained from the pancreas harboring pancreatic cancer needed to be further investigated

Is a dynamic MRI examination of the pancreas still necessary?

International Nuclear Information System (INIS)

Morakkabati-Spitz, N.; Willinek, W.A.; Falkenhausen, M. von; Flacke, S.; Schild, H.; Kreft, B.

2002-01-01

Purpose: Evaluation of the diagnostic potential of a dynamic MR examination of the pancreas. Material and Methods: Retrospective study on 49 patients who underwent MRI of the pancreas (2 insulinomas, 2 cystadenomas, 19 pancreatic carcinomas, 26 patients with chronic pancreatitis). Interpretation was done in two steps: Initial evaluation of T 2 -weighted TSE-sequences, T 1 -weighted gradient echo sequences before and after injection of Gadolinium-DTPA i.v. Afterwards, additional evaluation of a dynamic contrast-enhanced MRI series of the pancreas with four dynamic scans. Result: Dynamic MR examination of the pancreas is useful in case of insulinomas. However, in case of pancreatic cancer an additional dynamic MR examination of the pancreas does not provide further clinically relevant information. Conclusion: In patients with a suspicion of pancreatic cancer, the injection of contrast material should preferably be used for the performance of a contrast-enhanced MR angiography at the expense of a dynamic MR examination. (orig.) [de

Gatekeepers of pancreas: TEAD and YAP

OpenAIRE

Rodríguez Seguí, Santiago Andrés; Bessa, José

2017-01-01

The pancreas hosts some of the most debilitating and deadly diseases, including pancreatic cancer and diabetes mellitus. In autoimmune diabetes, for example, there is a massive destruction of the insulin producing cells of the pancreas. Pancreatic developmental defects can also result in a deficit of this cell type. To revert these important pancreatic diseases, researchers are currently trying to artificially generate insulin producing beta-cells for implantation and, in this way, suppress i...

Post-ERCP bacteremia caused by Alcaligenes xylosoxidans in a patient with pancreas cancer

Directory of Open Access Journals (Sweden)

Akcay Korhan

2006-09-01

Full Text Available Abstract Alcaligenes xylosoxidans is an aerobic, motile, oxidase and catalase positive, nonfermentative Gram negative bacillus. This bacterium has been isolated from intestine of humans and from various hospital or environmental water sources. A.xylosoxidans is both waterborne and results from the poor-hygienic conditions healthcare workers are in. In this case report, the bacteremia which appeared in a patient with pancreas cancer after ERCP was described.

Signal transduction of vitamin K3 for pancreas cancer therapy

Directory of Open Access Journals (Sweden)

Toshiyuki Tanahashi

2011-10-01

Full Text Available We characterized molecular mechanisms of vitamin K3 (VK3-induced inhibition of proliferation to evaluate VK3 effectiveness in treating advanced pancreatic cancer. A novel endoscopic drug delivery system, ultrasound injection technique, was used to study local effects of VK3. VK3 inhibited pancreas cancer cell growth by rapid phosphorylation of growth factor receptor and cellular signal factors such as extracellular signal-regulated kinase. VK3 also activated apoptosis, and apoptosis inhibitor antagonized the apoptosis pathway without inhibiting cell growth. Thiol antioxidant treatment completely abrogated VK3-induced ERK but not JNK phosphorylation or inhibition of proliferation. Non-thiol antioxidant did not affect ERK phosphorylation or growth inhibitory actions. Arylation was considered the main mechanism of VK3-induced growth inhibition through ERK activation. VK3 may lead to favorable outcomes in the treatment of pancreatic tumors. Detection of ERK phosphorylation in tissue is important to predict VK3 effect. Endoscopic ultrasound-guided fine-needle injection may be beneficial for treating pancreatic cancer with VK3.

Tension and Transformation in Pancreas Cancer: Can Phenotype Break Free from the Chrysalis of Genotype?

Science.gov (United States)

DuFort, Christopher C; Hingorani, Sunil R

2016-06-13

A recent study finds that impaired TGFβ signaling can initiate a positive feedback loop between increasing ECM stiffness and epithelial cell contractility in pancreas cancer. Even more surprising is the possibility that this phenotype can liberate the epithelium from dependence on the genetic events that transformed it. Copyright © 2016 Elsevier Inc. All rights reserved.

Getting a New Pancreas: Facts about Pancreas Transplants

Science.gov (United States)

... 2003 December 2006 March 2012 Getting A New Pancreas Facts About Pancreas Transplants American Society of Transplantation 1120 Route 73, ... the views of the Society. _________________________________________________________________ Getting a New Pancreas Facts About Pancreas Transplants When you get a ...

Economic Burden of Bladder Cancer Across the European Union.

Science.gov (United States)

Leal, Jose; Luengo-Fernandez, Ramon; Sullivan, Richard; Witjes, J Alfred

2016-03-01

More than 120,000 people are diagnosed annually with bladder cancer in the 28 countries of the European Union (EU). With >40,000 people dying of it each year, it is the sixth leading cause of cancer. However, to date, no systematic cost-of-illness study has assessed the economic impact of bladder cancer in the EU. To estimate the annual economic costs of bladder cancer in the EU for 2012. Country-specific cancer cost data were estimated using aggregate data on morbidity, mortality, and health care resource use, obtained from numerous international and national sources. Health care costs were estimated from expenditures on primary, outpatient, emergency, and inpatient care, as well as medications. Costs of unpaid care and lost earnings due to morbidity and early death were estimated. Bladder cancer cost the EU €4.9 billion in 2012, with health care accounting for €2.9 billion (59%) and representing 5% of total health care cancer costs. Bladder cancer accounted for 3% of all cancer costs in the EU (€143 billion) in 2012 and represented an annual health care cost of €57 per 10 EU citizens, with costs varying >10 times between the country with the lowest cost, Bulgaria (€8 for every 10 citizens), and highest cost, Luxembourg (€93). Productivity losses and informal care represented 23% and 18% of bladder cancer costs, respectively. The quality and availability of comparable cancer-related data across the EU need further improvement. Our results add to essential public health and policy intelligence for delivering affordable bladder cancer care systems and prioritising the allocation of public research funds. We looked at the economic costs of bladder cancer across the European Union (EU). We found bladder cancer to cost €4.9 billion in 2012, with health care accounting for €2.9 billion. Our study provides data that can be used to inform affordable cancer care in the EU. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All

Pancreas preservation for pancreas and islet transplantation

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Iwanaga, Yasuhiro; Sutherland, David E.R.; Harmon, James V.; Papas, Klearchos K.

2010-01-01

Purpose of review To summarize advances and limitations in pancreas procurement and preservation for pancreas and islet transplantation, and review advances in islet protection and preservation. Recent findings Pancreases procured after cardiac death, with in-situ regional organ cooling, have been successfully used for islet transplantation. Colloid-free Celsior and histidine-tryptophan-ketoglutarate preservation solutions are comparable to University of Wisconsin solution when used for cold storage before pancreas transplantation. Colloid-free preservation solutions are inferior to University of Wisconsin solution for pancreas preservation prior to islet isolation and transplantation. Clinical reports on pancreas and islet transplants suggest that the two-layer method may not offer significant benefits over cold storage with the University of Wisconsin solution: improved oxygenation may depend on the graft size; benefits in experimental models may not translate to human organs. Improvements in islet yield and quality occurred from pancreases treated with inhibitors of stress-induced apoptosis during procurement, storage, isolation or culture. Pancreas perfusion may be desirable before islet isolation and transplantation and may improve islet yields and quality. Methods for real-time, noninvasive assessment of pancreas quality during preservation have been implemented and objective islet potency assays have been developed and validated. These innovations should contribute to objective evaluation and establishment of improved pancreas preservation and islet isolation strategies. Summary Cold storage may be adequate for preservation before pancreas transplants, but insufficient when pancreases are processed for islets or when expanded donors are used. Supplementation of cold storage solutions with cytoprotective agents and perfusion may improve pancreas and islet transplant outcomes. PMID:18685343

Fatty Pancreas: Should We Be Concerned?

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Majumder, Shounak; Philip, Nissy A; Takahashi, Naoki; Levy, Michael J; Singh, Vijay P; Chari, Suresh T

The metabolic consequences of visceral fat deposition are well known, and the presence of intrapancreatic fat (IPF) has been recognized for decades. However, our knowledge about the distribution of fat in the pancreas and its clinical implications is in a nascent stage. Various terms have been proposed to describe IPF; for the purpose of this narrative review, we chose the general term fatty pancreas. Herein, we describe the radiologic, endoscopic, and histopathologic aspects of diagnosing fatty pancreas and provide an overview of the diseases associated with this condition. Our purpose is to highlight diagnostic challenges and identify specific clinical questions that would benefit from further study. As evident in this review, IPF is associated with various metabolic diseases, pancreatitis, pancreatic cancer, and precancer-yet establishing causality needs careful, further study.

Hippo Signaling Regulates Pancreas Development through Inactivation of Yap

Science.gov (United States)

Day, Caroline E.; Boerner, Brian P.; Johnson, Randy L.; Sarvetnick, Nora E.

2012-01-01

The mammalian pancreas is required for normal metabolism, with defects in this vital organ commonly observed in cancer and diabetes. Development must therefore be tightly controlled in order to produce a pancreas of correct size, cell type composition, and physiologic function. Through negative regulation of Yap-dependent proliferation, the Hippo kinase cascade is a critical regulator of organ growth. To investigate the role of Hippo signaling in pancreas biology, we deleted Hippo pathway components in the developing mouse pancreas. Unexpectedly, the pancreas from Hippo-deficient offspring was reduced in size, with defects evident throughout the organ. Increases in the dephosphorylated nuclear form of Yap are apparent throughout the exocrine compartment and correlate with increases in levels of cell proliferation. However, the mutant exocrine tissue displays extensive disorganization leading to pancreatitis-like autodigestion. Interestingly, our results suggest that Hippo signaling does not directly regulate the pancreas endocrine compartment as Yap expression is lost following endocrine specification through a Hippo-independent mechanism. Altogether, our results demonstrate that Hippo signaling plays a crucial role in pancreas development and provide novel routes to a better understanding of pathological conditions that affect this organ. PMID:23071096

Epidemiology of cancers of the liver, gall bladder, extrahepatic bile duct and pancreas in Nagasaki city from 1973 to 1982 with reference to atomic bomb exposure

International Nuclear Information System (INIS)

Takeshima, Fuminao; Shimokawa, Isao; Takashima, Kazuhiko

1990-01-01

This epidemiology study included 808 cases of liver cancers, 378 cases of gall bladder and extrahepatic bile duct cancer, and 312 cases of pancreas cancer registered at the Nagasaki Tumor Registry from 1973 to 1982, with emphasis on the relationship of these cancers to radiation exposure. The incidence of liver, gall bladder and extrahepatic bile duct cancer in both sexes tended to be higher in A-bomb survivors than in the nonexposed population, but were particularly significantly higher in male A-bomb survivors in each age-adjusted relative risk group. The incidence of pancreas cancer in females tended to be higher among A-bomb survivors than in the nonexposed population, and age-adjusted relative risk was significantly higher for female A-bomb survivors. No significant differences in relative distribution of histological type between exposed and nonexposed groups was observed. (author)

Comparison of Pancreas Juice Proteins from Cancer Versus Pancreatitis Using Quantitative Proteomic Analysis

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Chen, Ru; Pan, Sheng; Cooke, Kelly; Moyes, Kara White; Bronner, Mary P.; Goodlett, David R.; Aebersold, Ruedi; Brentnall, Teresa A.

2008-01-01

Objectives Pancreatitis is an inflammatory condition of the pancreas. However, it often shares many molecular features with pancreatic cancer. Biomarkers present in pancreatic cancer frequently occur in the setting of pancreatitis. The efforts to develop diagnostic biomarkers for pancreatic cancer have thus been complicated by the false-positive involvement of pancreatitis. Methods In an attempt to develop protein biomarkers for pancreatic cancer, we previously use quantitative proteomics to identify and quantify the proteins from pancreatic cancer juice. Pancreatic juice is a rich source of proteins that are shed by the pancreatic ductal cells. In this study, we used a similar approach to identify and quantify proteins from pancreatitis juice. Results In total, 72 proteins were identified and quantified in the comparison of pancreatic juice from pancreatitis patients versus pooled normal control juice. Nineteen of the juice proteins were overexpressed, and 8 were underexpressed in pancreatitis juice by at least 2-fold compared with normal pancreatic juice. Of these 27 differentially expressed proteins in pancreatitis, 9 proteins were also differentially expressed in the pancreatic juice from pancreatic cancer patient. Conclusions Identification of these differentially expressed proteins from pancreatitis juice provides useful information for future study of specific pancreatitis-associated proteins and to eliminate potential false-positive biomarkers for pancreatic cancer. PMID:17198186

Adverse drug reactions associated with the use of liraglutide in patients with type 2 diabetes - focus on pancreatitis and pancreas cancer

DEFF Research Database (Denmark)

Chalmer, Thor; Almdal, Thomas P; Vilsbøll, Tina

2014-01-01

Introduction: The glucagon-like peptide-1 (GLP-1) receptor agonist, liraglutide , is a widely used drug for the treatment of type 2 diabetes. Liraglutide is one of several incretin-based agents that have been suggested to be associated with pancreatitis and pancreas cancer. The suspicion accelera......Introduction: The glucagon-like peptide-1 (GLP-1) receptor agonist, liraglutide , is a widely used drug for the treatment of type 2 diabetes. Liraglutide is one of several incretin-based agents that have been suggested to be associated with pancreatitis and pancreas cancer. The suspicion....... However, a recently published analysis suggests a trend toward a slightly elevated risk of pancreatitis with GLP-1 receptor agonists (including liraglutide), which may become statistical significant as more data become available. Well-established side effects are of gastrointestinal origin, typical mild...

Measure of pancreas transection and postoperative pancreatic fistula.

Science.gov (United States)

Takahashi, Shinichiro; Gotohda, Naoto; Kato, Yuichiro; Konishi, Masaru

2016-05-15

In pancreaticoduodenectomy (PD), a standard protocol for pancreas transection has not been established although the method of pancreas transection might be involved in the occurrence of postoperative pancreatic fistula (POPF). This study aimed to compare whether pancreas transection by ultrasonically activated shears (UAS) or that by scalpel contributed more to POPF development. A prospective database of 171 patients who underwent PD for periampullary tumor at National Cancer Center Hospital East between January 2010 and June 2013 was reviewed. Among the 171 patients, 93 patients with soft pancreas were specifically included in this study. Surgical results and background were compared between patients with pancreas transection by UAS and scalpel to evaluate the effectiveness of UAS on reducing POPF. Body mass index, main pancreatic duct diameter, or other clinicopathologic factors that have been reported as predictive factors for POPF were not significantly different between the two groups. The incidence of all grades of POPF and that of grade B were significantly lower in the scalpel group (52%, 4%) than in the UAS group (74%, 42%). Postoperative complications ≥ grade III were also significantly fewer in the scalpel group. Scalpel transection was less associated with POPF than UAS transection in patients who underwent PD for soft pancreas. The method of pancreas transection plays an important role in the prevention of clinical POPF. Copyright © 2016 Elsevier Inc. All rights reserved.

Pancreas Transplantation

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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 ...

Whole-organ perfusion of the pancreas using dynamic volume CT in patients with primary pancreas carcinoma: acquisition technique, post-processing and initial results

International Nuclear Information System (INIS)

Kandel, Sonja; Kloeters, Christian; Meyer, Henning; Hein, Patrick; Rogalla, Patrik; Hilbig, Andreas

2009-01-01

The purpose of this study was to evaluate a whole-organ perfusion protocol of the pancreas in patients with primary pancreas carcinoma and to analyse perfusion differences between normal and diseased pancreatic tissue. Thirty patients with primary pancreatic malignancy were imaged on a 320-slice CT unit. Twenty-nine cancers were histologically proven. CT data acquisition was started manually after contrast-material injection (8 ml/s, 350 mg iodine/ml) and dynamic density measurements in the right ventricle. After image registration, perfusion was determined with the gradient-relationship technique and volume regions-of-interest were defined for perfusion measurements. Contrast time-density curves and perfusion maps were generated. Statistical analysis was performed using the Kolmogorov-Smirnov test for analysis of normal distribution and Kruskal-Wallis test (nonparametric ANOVA) with Bonferroni correction for multiple stacked comparisons. In all 30 patients the entire pancreas was imaged, and registration could be completed in all cases. Perfusion of pancreatic carcinomas was significantly lower than of normal pancreatic tissue (P < 0.001) and could be visualized on colored perfusion maps. The 320-slice CT allows complete dynamic visualization of the pancreas and enables calculation of whole-organ perfusion maps. Perfusion imaging carries the potential to improve detection of pancreatic cancers due to the perfusion differences. (orig.)

What Is the Pancreas?

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... Pancreas Function of the Pancreas What is the pancreas? The pancreas is a long flattened gland located ... controller of blood sugar levels. Where is the pancreas? The pancreas is located deep in the abdomen. ...

Targeting developmental regulators of zebrafish exocrine pancreas as a therapeutic approach in human pancreatic cancer

Directory of Open Access Journals (Sweden)

Nelson S. Yee

2012-02-01

Histone deacetylases (HDACs and RNA polymerase III (POLR3 play vital roles in fundamental cellular processes, and deregulation of these enzymes has been implicated in malignant transformation. Hdacs and Polr3 are required for exocrine pancreatic epithelial proliferation during morphogenesis in zebrafish. We aim to test the hypothesis that Hdacs and Polr3 cooperatively control exocrine pancreatic growth, and combined inhibition of HDACs and POLR3 produces enhanced growth suppression in pancreatic cancer. In zebrafish larvae, combination of a Hdac inhibitor (Trichostatin A and an inhibitor of Polr3 (ML-60218 synergistically prohibited the expansion of exocrine pancreas. In human pancreatic adenocarcinoma cells, combination of the HDAC inhibitor suberoylanilide hydroxamic acid (SAHA and ML-60218 produced augmented suppression of colony formation and proliferation, and induction of cell cycle arrest and apoptotic cell death. The enhanced cytotoxicity was associated with supra-additive upregulation of the pro-apoptotic regulator BAX and the cyclin-dependent kinase inhibitor p21CDKN1A. tRNAs have been shown to have pro-proliferative and anti-apoptotic roles, and SAHA-stimulated expression of tRNAs was reversed by ML-60218. These findings demonstrate that chemically targeting developmental regulators of exocrine pancreas can be translated into an approach with potential impact on therapeutic response in pancreatic cancer, and suggest that counteracting the pro-malignant side effect of HDAC inhibitors can enhance their anti-tumor activity.

Acinar Cell Carcinoma of the Pancreas with Colon Involvement

Directory of Open Access Journals (Sweden)

Naoki Asayama

2014-01-01

Full Text Available We report a case of acinar cell carcinoma of the pancreas with colon involvement that was difficult to distinguish from primary colon cancer. A 60-year-old man was admitted with a 1-month history of diarrhea. Contrast-enhanced computed tomography (CT revealed a large tumor (10.6×11.6 cm at the splenic flexure of the colon. Colonoscopy showed completely round ulcerative lesions, and biopsy revealed poorly differentiated adenocarcinoma. Left hemicolectomy, resection of the jejunum and pancreas body and tail, and splenectomy were performed based on a diagnosis of descending colon cancer (cT4N0M0, stage IIB, and surgery was considered to be curative. Diagnosis was subsequently confirmed as moderately differentiated acinar cell carcinoma of the pancreas by immunohistochemical staining (pT3N0M0, stage IIA. Multiple liver metastases with portal thrombosis were found 8 weeks postoperatively. Despite combination chemotherapy with oral S-1 and gemcitabine, the patient died of hepatic failure with no effect of chemotherapy 14 weeks postoperatively. Correct diagnosis was difficult to determine preoperatively from the clinical, CT, and colonoscopy findings. Moreover, the disease was extremely aggressive even after curative resection. Physicians should consider pancreatic cancer in the differential diagnosis of similar cases.

Purinergic signalling in the pancreas in health and disease

DEFF Research Database (Denmark)

Burnstock, G; Novak, I

2012-01-01

Pancreatic cells contain specialised stores for ATP. Purinergic receptors (P2 and P1) and ecto-nucleotidases are expressed in both endocrine and exocrine calls, as well as in stromal cells. The pancreas, especially the endocrine cells, were an early target for the actions of ATP. After the histor......Pancreatic cells contain specialised stores for ATP. Purinergic receptors (P2 and P1) and ecto-nucleotidases are expressed in both endocrine and exocrine calls, as well as in stromal cells. The pancreas, especially the endocrine cells, were an early target for the actions of ATP. After...... the historical perspective of purinergic signalling in the pancreas, the focus of this review will be the physiological functions of purinergic signalling in the regulation of both endocrine and exocrine pancreas. Next, we will consider possible interaction between purinergic signalling and other regulatory...... systems and their relation to nutrient homeostasis and cell survival. The pancreas is an organ exhibiting several serious diseases - cystic fibrosis, pancreatitis, pancreatic cancer and diabetes - and some are associated with changes in life-style and are increasing in incidence. There is upcoming...

Guidelines for the application of surgery and endoprostheses in the palliation of obstructive jaundice in advanced cancer of the pancreas

NARCIS (Netherlands)

van den Bosch, R. P.; van der Schelling, G. P.; Klinkenbijl, J. H.; Mulder, P. G.; van Blankenstein, M.; Jeekel, J.

1994-01-01

This study was set up to identify patient-related factors favoring the application of either surgery or endoprostheses in the palliation of obstructive jaundice in subsets of patients with cancer of the head of the pancreas or periampullary region. In the palliation of obstructive jaundice, surgical

Trends in cancer of the liver, gall bladder, bile duct, and pancreas in elderly in Denmark, 1980-2012

DEFF Research Database (Denmark)

Bjerregaard, Jon Kroll; Mortensen, Michael Bau; Pfeiffer, Per

2016-01-01

, mortality, prevalence and relative survival for these cancers.Materials and methods HBP-c was defined as ICD-10 codes C22 (liver), C23-24 (gall bladder), and C25 (pancreas). Data derived from the NORDCAN database with comparable data on cancer incidence, mortality, prevalence and relative survival.......Conclusion As the number of persons aged 80 years or more will increase dramatically in the following years, and our results show a gap in relative survival, it is important to continue to study this population in order to improve management and outcome....

Expression of receptors for gut peptides in human pancreatic adenocarcinoma and tumour-free pancreas

NARCIS (Netherlands)

Tang, C.; Biemond, I.; Offerhaus, G. J.; Verspaget, W.; Lamers, C. B.

1997-01-01

Gut hormones that modulate the growth of normal pancreas may also modulate the growth of cancers originating from pancreas. This study visualized and compared the receptors for cholecystokinin (CCK), bombesin (BBS), secretin and vasoactive intestinal peptide (VIP) in tumour-free tissue sections of

Heterotopic Pancreas: Histopathologic Features, Imaging Findings, and Complications.

Science.gov (United States)

Rezvani, Maryam; Menias, Christine; Sandrasegaran, Kumaresan; Olpin, Jeffrey D; Elsayes, Khaled M; Shaaban, Akram M

2017-01-01

Heterotopic pancreas is a congenital anomaly in which pancreatic tissue is anatomically separate from the main gland. The most common locations of this displacement include the upper gastrointestinal tract-specifically, the stomach, duodenum, and proximal jejunum. Less common sites are the esophagus, ileum, Meckel diverticulum, biliary tree, mesentery, and spleen. Uncomplicated heterotopic pancreas is typically asymptomatic, with the lesion being discovered incidentally during an unrelated surgery, during an imaging examination, or at autopsy. The most common computed tomographic appearance of heterotopic pancreas is that of a small oval intramural mass with microlobulated margins and an endoluminal growth pattern. The attenuation and enhancement characteristics of these lesions parallel their histologic composition. Acinus-dominant lesions demonstrate avid homogeneous enhancement after intravenous contrast material administration, whereas duct-dominant lesions are hypovascular and heterogeneous. At magnetic resonance imaging, the heterotopic pancreas is isointense to the orthotopic pancreas, with characteristic T1 hyperintensity and early avid enhancement after intravenous gadolinium-based contrast material administration. Heterotopic pancreatic tissue has a rudimentary ductal system in which an orifice is sometimes visible at imaging as a central umbilication of the lesion. Complications of heterotopic pancreas include pancreatitis, pseudocyst formation, malignant degeneration, gastrointestinal bleeding, bowel obstruction, and intussusception. Certain complications may be erroneously diagnosed as malignancy. Paraduodenal pancreatitis is thought to be due to cystic degeneration of heterotopic pancreatic tissue in the medial wall of the duodenum. Recognizing the characteristic imaging features of heterotopic pancreas aids in differentiating it from cancer and thus in avoiding unnecessary surgery. © RSNA, 2017.

Metastatic tumor of the pancreas: helical CT findings

International Nuclear Information System (INIS)

Lee, Soon Jin; Lee, Won Jae; Lim, Hyo Keun; Kim, Seung Hoon; Kim, Kyeong Ah; Choi, Sang Hee; Jang, Hyun Jung; Lee, Ji Yeon

2000-01-01

To analyze the helical computed tomographic (CT) findings of distant metastatic tumors to the pancreas and to determine the differential points between these and primary pamcreatic carcinomas. We sruveyed 22 patients with metastatic tumor of the pancreas, proven on the basis of clinical and pathological findings. Seventeen patients were men, and five were women, and their ages ranged between 36 and 83 years. Their primary conditions were lung cancer (n=3D15), rectal cancer (n=3D2), melanoma of the foot, chondrosarcoma of the sacrum, cervical cancer, leiomyosarcoma of the uterus, and extragonadal choriocarcinoma of the mediastinum. We retrospectively reviewed the abdominal helical CT findings, analysing the number, location, size and attenuation of masses, as well as secondary change, which included dilatation of the pancreatic and biliary ducts and invasion of peripancreatic tissue or vessels. We also evaluated the differential findings of primary pancreatic cancer. Sixteen patients had a solitary focal mass, while in five, two masses were present. Among the 22 patients, low-density nodular masses were present in 21; in the other, in whom multiple metastasis from chondrosarcoma had occurred, there was dense calcification. The size of metastatic masses varied, ranging from 0.6 to 6 cm in diameter. The pancreatic duct proximal to the mass was dilated in ten cases, while the bile duct was dilated in six. The metastatic masses masses demonstrated no peripancreatic or vascular invasion, though they showed a discrete margin and contour bulging. Single metastasis to the pancreas was most common, and metastatic masses had a discrete margin, with contour bulging. There was no peripancreatic or vascular invasion. If the metastasis involved a single low-attenuated mass, however, with pancreatic or biliary dilatation, it was difficult to differentiate this from primary pancreatic cancer. (author)

SU-E-J-65: Motion Difference Between the Pancreas and Nearby Veins for Pancreas Motion Monitoring Using Ultrasound During Radiation Therapy

International Nuclear Information System (INIS)

Omari, E; Erickson, B; Li, X; Zhang, J

2015-01-01

Purpose: As it is generally difficult to outline the pancreas on an ultrasound b-mode image, visualized structures such as the portal or the splenic veins are assumed to have the same motion as the pancreas. These structures can be used as a surrogate for monitoring pancreas motion during radiation therapy (RT) delivery using ultrasound. To verify this assumption, we studied the motion difference between the head of the pancreas, the portal vein, the tail of the pancreas, and splenic vein. Methods: 4DCT data acquired during RT simulation were analyzed for a total of 5 randomly selected patients with pancreatic cancer. The data was sorted into 10 respiratory phases from 0% to 90% (0%: end of the inspiration, 50%: end of expiration) . The head of the pancreas (HP), tail of the pancreas (TP), portal vein (PV), and splenic vein (SV) were contoured on all 10 phases. The volume change and motion were measured in the left-right (LR), anterior-superior (AP), and superior-inferior (SI) directions. Results: The volume change for all patients/phases were: 1.2 ± 3% for HP, 0.78 ± 1.6% for PV, 2.5 ± 2.9% for TP, and 0.53 ± 2.1% for SV. Motion for each structure was estimated from the centroid displacements due to the uniformity of the structures and the small volume change. The measured motion between HP and PV was: LR: 0.1 ± 0.17 mm, AP: 0.04 ± 0.1 mm, SI: 0.17 ± 0.16 mm and between TP and the PV was: LR: 0.05 ± 0.3 mm, AP: 0.1 ± 0.4 mm, SI: 0.01 ± 0.022 mm. Conclusion: There are small motion differences between the portal vein and the head of the pancreas, and the splenic vein and the tail of the pancreas. This suggests the feasibility of utilizing these features for monitoring the pancreas motion during radiation therapy

11C-harmine as a potential PET tracer for ductal pancreas cancer: in vitro studies

International Nuclear Information System (INIS)

Herlin, G.; Persson, B.; Laangstroem, B.; Aspelin, P.; Bergstroem, M.

2003-01-01

Our objective was to find a tracer in diagnosing human pancreatic cancer using positron emission tomography (PET). For this purpose in vitro test of pancreatic tissues with autoradiography was used. Autoradiography was performed with 11 C-harmine (a MAO-A-inhibitor) with and without competitive inhibition. Tissue preparations were obtained from normal human pancreas and pancreatic cancer. The uptake was compared with rat brain or pig brain, tissues with high expression of MAO-A. Nine autoradiography studies on 16 samples from five different human pancreatic cancers gave a significant level of specific binding of 11 C-harmine in 13, and 3 samples did not give a significant level of specific binding of 11 C-harmine. All 16 samples were analysed with autoradiography. Compared with rat brain, the uptake in the human cancers varied between 9 and 43% except for one tissue preparation which had a too low value for measurement. This study shows expression of MAO-A in human pancreatic cancer. This is readily characterised in vitro. The potential use of 11 C-harmine in the diagnosis of pancreatic cancer using PET might be limited, but further PET studies are necessary. (orig.)

[Multidisciplinary approach to surgical disorders of the pancreas in children].

Science.gov (United States)

Šnajdauf, J; Rygl, M; Petrů, O; Frýbová, B; Náhlovský, J; Mixa, V; Keil, R; Bronský, J; Kynčl, M; Kodet, R

2018-01-01

Surgical diseases of the pancreas in children are not common and may be associated with significant morbidity and potential mortality. A multidisciplinary approach is essential for correct diagnosis, surgical strategy and postoperative as well as follow-up care. Retrospective analysis of patients operated on due to a pathological lesion of the pancreas focused on diagnostics, operating procedures, postoperative complications, and long-term results. Between 1991 and 2016, eighty-nine children were treated in our department for a pathologic lesion of the pancreas. 39 of them were boys and 50 were girls. Mean age of the patients was 9.3 years (1 month-18.4 years). Patients were followed from the operation to the age of 19, after which they were referred for follow-up to adult specialists. The indications for surgery were trauma in 34 children, solid pseudopapillary tumor in 23 children, biopsy in 10, hyperinsulinism in 8, chronic pancreatitis in 4, pancreatic cyst in 3, insulinoma in 3, carcinoma in 2, and serous cystadenoma and pancreas divisum in one patient. The most frequent procedures performed on the pancreas were distal pancreatectomy in 35 cases, the duodenum-preserving pancreatic head resection in 23 cases, pseudocystogastroanastomosis in 11 cases, 9095% pancreatic resection in 5 cases, Whipple operation in two cases, Puestow procedure in one case, tumor enucleation in one case, and tumor biopsy for cancer in one case. In 5 patients after major pancreatic injury, ERCP and papillotomy with insertion of a stent into the pancreatic duct was performed. 3 patients died, one after a polytrauma with severe pancreatic injury and two patients with pancreatic cancer. Pancreatic surgery in children is not a common operation, and individual as well as institutional experience remains limited. After more than 20 years of experience with pancreatic surgery, we believe that close cooperation with surgeons, pediatric gastroenterologists, radiologists, anesthesiologists

Precision Medicine for Advanced Pancreas Cancer: The Individualized Molecular Pancreatic Cancer Therapy (IMPaCT) Trial.

Science.gov (United States)

Chantrill, Lorraine A; Nagrial, Adnan M; Watson, Clare; Johns, Amber L; Martyn-Smith, Mona; Simpson, Skye; Mead, Scott; Jones, Marc D; Samra, Jaswinder S; Gill, Anthony J; Watson, Nicole; Chin, Venessa T; Humphris, Jeremy L; Chou, Angela; Brown, Belinda; Morey, Adrienne; Pajic, Marina; Grimmond, Sean M; Chang, David K; Thomas, David; Sebastian, Lucille; Sjoquist, Katrin; Yip, Sonia; Pavlakis, Nick; Asghari, Ray; Harvey, Sandra; Grimison, Peter; Simes, John; Biankin, Andrew V

2015-05-01

Personalized medicine strategies using genomic profiling are particularly pertinent for pancreas cancer. The Individualized Molecular Pancreatic Cancer Therapy (IMPaCT) trial was initially designed to exploit results from genome sequencing of pancreatic cancer under the auspices of the International Cancer Genome Consortium (ICGC) in Australia. Sequencing revealed small subsets of patients with aberrations in their tumor genome that could be targeted with currently available therapies. The pilot stage of the IMPaCT trial assessed the feasibility of acquiring suitable tumor specimens for molecular analysis and returning high-quality actionable genomic data within a clinically acceptable timeframe. We screened for three molecular targets: HER2 amplification; KRAS wild-type; and mutations in DNA damage repair pathways (BRCA1, BRCA2, PALB2, ATM). Tumor biopsy and archived tumor samples were collected from 93 patients and 76 were screened. To date 22 candidate cases have been identified: 14 KRAS wild-type, 5 cases of HER2 amplification, 2 mutations in BRCA2, and 1 ATM mutation. Median time from consent to the return of validated results was 21.5 days. An inability to obtain a biopsy or insufficient tumor content in the available specimen were common reasons for patient exclusion from molecular analysis while deteriorating performance status prohibited a number of patients from proceeding in the study. Documenting the feasibility of acquiring and screening biospecimens for actionable molecular targets in real time will aid other groups embarking on similar trials. Key elements include the need to better prescreen patients, screen more patients, and offer more attractive clinical trial options. ©2015 American Association for Cancer Research.

Contribution of double-labelling scintigraphy to the diagnosis of pancreas tumours

International Nuclear Information System (INIS)

Godin, Rene.

1975-01-01

A general discussion on the pancreas is followed by an attempt to show the progress made in pancreatic scintigraphy, with regard firstly to the improvement of equipment and secondly to the discovery of a still imperfect indicator, 75 Se-selenomethionine, the biological behavior, toxicity and dosimetry of which are studied. The 'research material' is then described, together with the working procedure as adopted by the CHU and the Paul Papin Centre. The results examined only concern observations for which a scintigraphic and anatomic comparison or failing this at least a reliable dignosis is available. Besides observations of cancers and false cysts of the pancreas some others are kept because they help to explain certain difficulties of interpretation of pancreatic scintigraphy. The discussion falls into several parts: - Different criteria for the interpretation of scintigraphs; - Diagnostic contribution of scintigraphy; - Exact place of this method in the positive diagnosis of pancreas cancers, then false cysts, by comparison with other means of investigation [fr

Age of diagnosis of breast cancer in china: almost 10 years earlier than in the United States and the European union.

Science.gov (United States)

Song, Qing-Kun; Li, Jing; Huang, Rong; Fan, Jin-Hu; Zheng, Rong-Shou; Zhang, Bao-Ning; Zhang, Bin; Tang, Zhong-Hua; Xie, Xiao-Ming; Yang, Hong-Jian; He, Jian-Jun; Li, Hui; Li, Jia-Yuan; Qiao, You-Lin; Chen, Wan-Qing

2014-01-01

The study aimed to describe the age distribution of breast cancer diagnosis among Chinese females for comparison with the United States and the European Union, and provide evidence for the screening target population in China. Median age was estimated from hospital databases from 7 tertiary hospitals in China. Population-based data in China, United States and European Union was extracted from the National Central Cancer Registry, SEER program and GLOBOCAN 2008, respectively. Age-standardized distribution of breast cancer at diagnosis in the 3 areas was estimated based on the World Standard Population 2000. The median age of breast cancer at diagnosis was around 50 in China, nearly 10 years earlier than United States and European Union. The diagnosis age in China did not vary between subgroups of calendar year, region and pathological characteristics. With adjustment for population structure, median age of breast cancer at diagnosis was 50~54 in China, but 55~59 in United States and European Union. The median diagnosis age of female breast cancer is much earlier in China than in the United States and the European Union pointing to racial differences in genetics and lifestyle. Screening programs should start at an earlier age for Chinese women and age disparities between Chinese and Western women warrant further studies.

Congenital anomalies, hereditary diseases of the pancreas, acute and chronic pancreatitis

International Nuclear Information System (INIS)

Brambs, Hans-Juergen; Juchems, Markus

2011-01-01

The most important congenital anomalies include pancreas divisum, annular pancreas and ectopic pancreas. Patients with pancreas divisum may be more susceptible to acute or chronic pancreatitis and patients with an annular pancreas may develop duodenal stenosis. In pancreas divisum the key finding is the visualization of the main duct draining into the duodenum via the small papilla, separated from the common bile duct. Annular pancreas may show as a well defined ring of pancreatic tissue that encircles the duodenum. Ectopic pancreas is usually asymptomatic but may give rise to abdominal complaints and may be confused with submucosal tumors. Acute pancreatitis is classified as mild or severe. In mild forms ultrasound is the imaging modality of choice whereas in severe forms with extensive pancreatic and peripancreatic necroses computed tomography is the favored method. It is crucial to identify signs and criteria that come along with an increased risk of infection of the necroses. MRI plays an inferior role in the assessment of acute pancreatitis. Chronic pancreatitis is a longstanding inflammatory and fibrosing process causing pain and loss of function. Cross-section imaging is particularly in demand for the detection of complications and the differentiation from pancreatic cancer. Autoimmune pancreatitis is a unique form of chronic pancreatitis characterized by lymphoplasmacytic infiltration and fibrosis, and favourable response to corticosteroid treatment. (orig.)

Normal Pancreas Anatomy

Science.gov (United States)

... hyphen, e.g. -historical Searches are case-insensitive Pancreas Anatomy Add to My Pictures View /Download : Small: ... 1586x1534 View Download Large: 3172x3068 View Download Title: Pancreas Anatomy Description: Anatomy of the pancreas; drawing shows ...

Imaging of the pancreas using positron emission tomography with N-13 ammonia

International Nuclear Information System (INIS)

Hayashi, N.; Tamaki, N.; Yamamoto, K.; Senda, M.; Yonekura, Y.; Saji, H.; Nishizawa, S.; Adachi, H.; Torizuka, K.

1986-01-01

A new technique for imaging the pancreas was developed using positron emission tomography (PET) with N-13 ammonia. Four healthy volunteers and 15 patients with pancreatic diseases were studied. After intravenous injection of 10-20 mCi of N-13 ammonia, serial PET scans were obtained every 150 seconds. In the healthy subjects, the pancreas was clearly visualized from the earliest scan. Scans in all ten patients with pancreatic cancer were abnormal. In five patients tumors were visualized as hot spots. When there was severe associated pancreatitis due to pancreatic duct obstruction by tumor, the radionuclide accumulation in the pancreas was remarkably low

Annular pancreas

Science.gov (United States)

... page: //medlineplus.gov/ency/article/001142.htm Annular pancreas To use the sharing features on this page, please enable JavaScript. An annular pancreas is a ring of pancreatic tissue that encircles ...

Gemcitabine-Based Combination Chemotherapy Followed by Radiation With Capecitabine as Adjuvant Therapy for Resected Pancreas Cancer

International Nuclear Information System (INIS)

Desai, Sameer; Ben-Josef, Edgar; Griffith, Kent A.; Simeone, Diane; Greenson, Joel K.; Francis, Isaac R.; Hampton, Janet; Colletti, Lisa; Chang, Alfred E.; Lawrence, Theodore S.; Zalupski, Mark M.

2009-01-01

Purpose: To report outcomes for patients with resected pancreas cancer treated with an adjuvant regimen consisting of gemcitabine-based combination chemotherapy followed by capecitabine and radiation. Patients and Methods: We performed a retrospective review of a series of patients treated at a single institution with a common postoperative adjuvant program. Between January 2002 and August 2006, 43 resected pancreas cancer patients were offered treatment consisting of 4, 21-day cycles of gemcitabine 1 g/m 2 intravenously over 30 min on Days 1 and 8, with either cisplatin 35 mg/m 2 intravenously on Days 1 and 8 or capecitabine 1500 mg/m 2 orally in divided doses on Days 1-14. After completion of combination chemotherapy, patients received a course of radiotherapy (54 Gy) with concurrent capecitabine (1330 mg/m 2 orally in divided doses) day 1 to treatment completion. Results: Forty-one patients were treated. Median progression-free survival for the entire group was 21.7 months (95% confidence interval 13.9-34.5 months), and median overall survival was 45.9 months. In multivariate analysis a postoperative CA 19-9 level of ≥180 U/mL predicted relapse and death. Toxicity was mild, with only two hospitalizations during adjuvant therapy. Conclusions: A postoperative adjuvant program using combination chemotherapy with gemcitabine and either cisplatin or capecitabine followed by radiotherapy with capecitabine is tolerable and efficacious and should be considered for Phase III testing in this group of patients.

Pancreatic Stellate Cells : A Starring Role in Normal and Diseased Pancreas

Directory of Open Access Journals (Sweden)

Minoti eApte

2012-08-01

Full Text Available While the morphology and function of cells of the exocrine and endocrine pancreas have been studied over several centuries, one important cell type in the gland, the pancreatic stellate cell (PSC, had remained undiscovered until as recently as twenty years ago. Even after its first description in 1982, it was to be another 16 years before its biology could begin to be studied, because it was only in 1998 that methods were developed to isolate and culture PSCs from rodent and human pancreas. PSCs are now known to play a critical role in pancreatic fibrosis, a consistent histological feature of two major diseases of the pancreas - chronic pancreatitis and pancreatic cancer. In health, PSCs maintain normal tissue architecture via regulation of the synthesis and degradation of extracellular matrix (ECM proteins. Recent studies have also implied other additional functions for PSCs as progenitor cells, immune cells or intermediaries in exocrine pancreatic secretion in humans.During pancreatic injury, PSCs transform from their quiescent phase into an activated, myofibroblast-like phenotype that secretes excessive amounts of ECM proteins leading to the fibrosis of chronic pancreatitis and pancreatic cancer. An ever increasing number of factors that stimulate and/or inhibit PSC activation via paracrine and autocrine pathways are being identified and characterized. It is also now established that PSCs interact closely with pancreatic cancer cells to facilitate cancer progression. Based on these findings, several therapeutic strategies have been examined in experimental models of chronic pancreatitis as well as pancreatic cancer, in a bid to inhibit/retard PSC activation and thereby alleviate chronic pancreatitis or reduce tumour growth in pancreatic cancer. The challenge that remains is to translate these pre-clinical developments into clinically applicable treatments for patients with chronic pancreatitis and pancreatic cancer.

SFRO booklets - The radiotherapy of cancers: of anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder for a better understanding of radiotherapy, sarcoma radiotherapy - To better understand your treatment

International Nuclear Information System (INIS)

Leroy, Thomas; Mornex, Francoise; Peiffert, Didier; Thariat, Juliette; Faivre, Jean-Christophe; Huguet, Florence; Vendrely, Veronique; Barillot, Isabelle; Janoray, Guillaume; Bibault, Jean-Emmanuel; Antoni, Delphine; Crehange, Gilles; Meillan, Nicolas; Pichon, Baptiste; Biau, Julian; Pointreau, Yoann; Mirabel, Xavier; Leysalle, Axel; Claren, Audrey; Cartier, Lysian; Chand, Mari-Eve; Jacob, Julian; Renard-Oldrini, Sophie; Le Pechoux, Cecile; Ducassou, Anne; Moureau-Zabotto, Laurence; Lagrange, Jean Leon; Molina, Sarah

2016-07-01

This document gathers several booklets which, for different types of cancers, propose information regarding the anatomy and location of the cancer, its diagnosis, possible treatments, secondary effects during treatment, some practical advices, issues related to the post-treatment period, associations and other resources which can be useful for patient information, and a glossary of the main terms used for this cancer and its treatment. Cancer types are anal canal (Anus), brain, mediastinum, pancreas, lung, prostate, rectum, breast, upper aero-digestive tract (ENT cancers), cervix, endometrium (cervical cancers), and bladder cancers

Artifical Pancreas

Science.gov (United States)

Fei, Jiangfeng

2013-03-01

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.

[A case of recurrent transverse colon cancer invading the pancreas and duodenum successfully treated with biliary and duodenal stenting].

Science.gov (United States)

Tonooka, Toru; Yoshioka, Shigeru; Shiobara, Masayuki; Wakatsuki, Kazuo; Kataoka, Masaaki; Arai, Shuka; Miyazawa, Kotaro; Nakada, Shinichiro; Kita, Kazuhiko; Saito, Hirofumi; Nomoto, Hiromasa; Usui, Masatoshi; Yabiki, Masashi; Ota, Yuki; Oeda, Yoshio

2013-11-01

We report a case of recurrent transverse colon cancer invading the pancreas and duodenum that was successfully treated with biliary and duodenal stenting. A 46-year-old man underwent ascending colostomy for the treatment of obstructive transverse colon cancer with hepatic metastasis. Chemotherapy achieved a partial response, but the levels of tumor markers later began to rise again. He then underwent right hemicolectomy and partial hepatectomy. Post-operative chemotherapy was administered, but the recurrent tumor caused obstructive jaundice and duodenal obstruction. These were successfully treated with biliary and duodenal stenting, and the patient was able to remain at home and maintain his quality of life.

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

International Nuclear Information System (INIS)

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

1988-01-01

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

Determination of acquisition frequency for intrafractional motion of pancreas in CyberKnife radiotherapy.

Science.gov (United States)

Zhang, Huailing; Zhao, Guoru; Djajaputra, David; Xie, Yaoqin

2014-01-01

To report the characteristics of pancreas motion as tracked using implanted fiducials during radiotherapy treatments with CyberKnife. Twenty-nine patients with pancreas cancer treated using CyberKnife system were retrospectively selected for this study. During the treatment, the deviation is examined every 3-4 nodes (~45 s interval) and compensated by the robot. The pancreas displacement calculated from X-ray images acquired within the time interval between two consecutive couch motions constitute a data set. A total of 498 data sets and 4302 time stamps of X-ray images were analyzed in this study. The average duration for each data set is 634 s. The location of the pancreas becomes more dispersed as the time elapses. The acquisition frequency depends on the prespecified movement distance threshold of pancreas. If the threshold between two consecutive images is 1 mm, the acquisition frequency should be less than 30 s, while if the threshold is 2 mm, the acquisition frequency can be around 1 min. The pancreas target moves significantly and unpredictably during treatment. Effective means of compensating the intrafractional movement is critical to ensure adequate dose coverage of the tumor target.

The Normal Fetal Pancreas.

Science.gov (United States)

Kivilevitch, Zvi; Achiron, Reuven; Perlman, Sharon; Gilboa, Yinon

2017-10-01

The aim of the study was to assess the sonographic feasibility of measuring the fetal pancreas and its normal development throughout pregnancy. We conducted a cross-sectional prospective study between 19 and 36 weeks' gestation. The study included singleton pregnancies with normal pregnancy follow-up. The pancreas circumference was measured. The first 90 cases were tested to assess feasibility. Two hundred ninety-seven fetuses of nondiabetic mothers were recruited during a 3-year period. The overall satisfactory visualization rate was 61.6%. The intraobserver and interobserver variability had high interclass correlation coefficients of of 0.964 and 0.967, respectively. A cubic polynomial regression described best the correlation of pancreas circumference with gestational age (r = 0.744; P pancreas circumference percentiles for each week of gestation were calculated. During the study period, we detected 2 cases with overgrowth syndrome and 1 case with an annular pancreas. In this study, we assessed the feasibility of sonography for measuring the fetal pancreas and established a normal reference range for the fetal pancreas circumference throughout pregnancy. This database can be helpful when investigating fetomaternal disorders that can involve its normal development. © 2017 by the American Institute of Ultrasound in Medicine.

Appearance of the aging pancreas on CT scans: Implications in diagnosis of pancreatic carcinoma

International Nuclear Information System (INIS)

Mattison, G.R.; Francis, I.R.; Glazer, G.M.; Trenkner, S.W.

1986-01-01

Because early pancreatic cancer may not appear on CT as a frank mass, the CT-based diagnosis relies on detection of subtle changes such as focal loss of lobulation or asymmetry in the distribution of tissue. The author studied the normal pancreas in 140 patients of different ages to determine if there is an overlap in the appearance of the normal aging pancreas and subtle signs of pancreatic cancer. Both contour lobulation and fatty infiltration were found to increase with age and involved the pancreatic body and tail more than the head. These normal age-related changes should be recognized to avoid overdiagnosing pancreatic head masses

INTRAOPERATIVE IRRADIATION OF THE CANINE PANCREAS - SHORT-TERM EFFECTS

NARCIS (Netherlands)

HEIJMANS, HJ; MEHTA, DM; KLEIBEUKER, JH; SLUITER, WJ; OLDHOFF, J; HOEKSTRA, HJ

1993-01-01

Intraoperative electron beam radiotherapy (IORT) is clinically used as a potential adjunctive treatment to surgery of locally advanced pancreatic and gastric cancer. The tolerance of the pancreas to IORT was studied in 15 adult beagles, divided in 3 groups of 5 beagles in which 25, 30 or 35 Gy IORT

Synchronous Primary Tumors of the Kidney and Pancreas: Case ...

African Journals Online (AJOL)

... of the kidney and pancreas. We present a 62-year-old man who had weight loss of 9 kg and epigastric pain. Findings showed a Furhman grade II renal papillary carcinoma confined to the kidney and a synchronous well differentiated pancreatic ductal adenocarcinoma. Key Words: Synchronous double cancer, renal cell ...

Pancreas transplant - slideshow

Science.gov (United States)

... this page: //medlineplus.gov/ency/presentations/100129.htm Pancreas transplant - series—Normal anatomy To use the sharing ... to slide 6 out of 6 Overview The pancreas resides in the back of the abdomen. It ...

National Pancreas Foundation

Science.gov (United States)

... Stay Informed - Join The Fight Animated Pancreas Patient Animations, Expert and Patient interviews on Pancreas Diseases State ... pancreatic experts at the American Pancreatic Association … Continue Reading More NPF News Social Media Post Read More ...

Is PET/CT efficient tool to evaluate the response after stereotactic radiation therapy for pancreas cancer?

International Nuclear Information System (INIS)

Kim, Mi Sook; Yoo, Seong Yul; Cho, Chul Koo

2005-01-01

In pancreas cancer, to evaluate the efficacy of PET/CT as tool to check the response after stereotactic radiation therapy and to define functional imaging role of PET/CT as alterative tool of computed tomography. From November 2003 to December 2004, among locally advanced pancreas cancer patients treated by stereotactic radiation therapy using CyberKnife(CK), 14 were evaluated by PET/CT before and after treatment. Four patients took PET/CT one month after CK, 4 patients 2 months after CK, and 6 patients 3 months after CK as the first evaluation of treatment. All of patients were also evaluated by CT or CA19-9 tumor antigen with the range of 1-2 months after CK. In addition of PET/CT to CT, lymph node metastasis were revealed as positive in 4 patients who had negative finding on CT. Furthermore, patients who showed partial or complete response on PET/CT findings that checked within 3 months after CK have significantly longer median survival time than patients who showed no response or disease progression(13 months and 9 months, respectively). Responses based on CA19-9 tumor antigen or CT, however, showed no significant difference in terms of median survival time. PET/CT can provide more information for lymph node metastasis compared to CT alone. It is very helpful for delineation of tumor extent for CK planning. And initial response on PET/CT scan could be a significant prognostic factor rather than response on CA19-9 level or CT. In the future, more study is necessary to evaluate if PET/CT could substitute CT and finally CT could be omitted during follow-up period after CK

Glypican1 identifies cancer exosomes and facilitates early detection of cancer

Science.gov (United States)

Melo, Sonia A.; Luecke, Linda B.; Kahlert, Christoph; Fernandez, Agustin F.; Gammon, Seth T.; Kaye, Judith; LeBleu, Valerie S.; Mittendorf, Elizabeth A.; Weitz, Juergen; Rahbari, Nuh; Reissfelder, Christoph; Pilarsky, Christian; Fraga, Mario F.; Piwnica-Worms, David; Kalluri, Raghu

2016-01-01

Summary Exosomes are lipid bilayer-enclosed extracellular vesicles (EVs) that contain proteins and nucleic acids. They are secreted by all cells and circulate in the blood. Specific detection and isolation of cancer cell-derived exosomes in circulation is currently lacking. Using mass spectrometry analyses, we identified a cell surface proteoglycan, glypican-1 (GPC1), specifically enriched on cancer cell-derived exosomes. GPC1+ circulating exosomes (crExos) were monitored and isolated using flow cytometry from the serum of cancer patients and mice with cancer. GPC1+ crExos were detected in the serum of patients with pancreas cancer with absolute specificity and sensitivity, distinguishing healthy subjects and patients with a benign pancreas disease from patients with early and late stage pancreas cancer. Levels of GPC1+ crExos correlate with tumor burden and survival in patients pre- and post-surgical tumor resection. GPC1+ crExos from patients and from mice with spontaneous pancreas tumors driven by oncogenic KRAS contained RNA with specific KRAS mutation, and it emerges as a reliable biomarker for the detection of PanIN lesions despite negative signal by MRI in mice. GPC1+ crExos may serve as a potential non-invasive diagnostic and screening tool to detect early stages of pancreas cancer to facilitate possible curative surgical therapy. PMID:26106858

Annular pancreas (image)

Science.gov (United States)

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 ...

Determination of Acquisition Frequency for Intrafractional Motion of Pancreas in CyberKnife Radiotherapy

Directory of Open Access Journals (Sweden)

Huailing Zhang

2014-01-01

Full Text Available Purpose. To report the characteristics of pancreas motion as tracked using implanted fiducials during radiotherapy treatments with CyberKnife. Methods and Materials. Twenty-nine patients with pancreas cancer treated using CyberKnife system were retrospectively selected for this study. During the treatment, the deviation is examined every 3-4 nodes (~45 s interval and compensated by the robot. The pancreas displacement calculated from X-ray images acquired within the time interval between two consecutive couch motions constitute a data set. Results. A total of 498 data sets and 4302 time stamps of X-ray images were analyzed in this study. The average duration for each data set is 634 s. The location of the pancreas becomes more dispersed as the time elapses. The acquisition frequency depends on the prespecified movement distance threshold of pancreas. If the threshold between two consecutive images is 1 mm, the acquisition frequency should be less than 30 s, while if the threshold is 2 mm, the acquisition frequency can be around 1 min. Conclusions. The pancreas target moves significantly and unpredictably during treatment. Effective means of compensating the intrafractional movement is critical to ensure adequate dose coverage of the tumor target.

Pancreatic Metastasis from Prostate Cancer

Directory of Open Access Journals (Sweden)

Julian Jacob

2010-01-01

Full Text Available The pancreas is an unusual location for metastases from other primary cancers. Rarely, pancreatic metastases from kidney or colorectal cancers have been reported. However, a variety of other cancers may also spread to the pancreas. We report an exceptional case of pancreatic metastasis from prostate cancer. Differences in management between primary and secondary pancreatic tumors make recognition of metastases to the pancreas an objective of first importance. Knowledge of unusual locations for metastatic spread will reduce diagnostic delay and lead to a timely delivery of an appropriate treatment.

Endoscopic Ultrasound Elastography: Current Clinical Use in Pancreas.

Science.gov (United States)

Mondal, Utpal; Henkes, Nichole; Patel, Sandeep; Rosenkranz, Laura

2016-08-01

Elastography is a newer technique for the assessment of tissue elasticity using ultrasound. Cancerous tissue is known to be stiffer (hence, less elastic) than corresponding healthy tissue, and as a result, could be identified in an elasticity-based imaging. Ultrasound elastography has been used in the breast, thyroid, and cervix to differentiate malignant from benign neoplasms and to guide or avoid unnecessary biopsies. In the liver, elastography has enabled a noninvasive and reliable estimate of fibrosis. Endoscopic ultrasound has become a robust diagnostic and therapeutic tool for the management of pancreatic diseases. The addition of elastography to endoscopic ultrasound enabled further characterization of pancreas lesions, and several European and Asian studies have reported encouraging results. The current clinical role of endoscopic ultrasound elastography in the management of pancreas disorders and related literature are reviewed.

A study of MRI-guided diffuse fluorescence molecular tomography for monitoring PDT effects in pancreas cancer

Science.gov (United States)

Samkoe, Kimberley S.; Davis, Scott C.; Srinivasan, Subhadra; O'Hara, Julia A.; Hasan, Tayyaba; Pogue, Brian W.

2009-06-01

Over the last several decades little progress has been made in the therapy and treatment monitoring of pancreas adenocarcinoma, a devastating and aggressive form of cancer that has a 5-year patient survival rate of 3%. Currently, investigations for the use of interstitial Verteporfin photodynamic therapy (PDT) are being undertaken in both orthotopic xenograft mouse models and in human clinical trials. In the mouse models, magnetic resonance (MR) imaging has been used as a measure of surrogate response to Verteporfin PDT; however, MR imaging alone lacks the molecular information required to assess the metabolic function and growth rates of the tumor immediately after treatment. We propose the implementation of MR-guided fluorescence tomography in conjunction with a fluorescently labeled (IR-Dye 800 CW, LI-COR) epidermal growth factor (EGF) as a molecular measure of surrogate response. To demonstrate the effectiveness of MR-guided diffuse fluorescence tomography for molecular imaging, we have used the AsPC-1 (+EGFR) human pancreatic adenocarcinoma in an orthotopic mouse model. EGF IRDye 800CW was injected 48 hours prior to imaging. MR image sequences were collected simultaneously with the fluorescence data using a MR-coupled diffuse optical tomography system. Image reconstruction was performed multiple times with varying abdominal organ segmentation in order to obtain a optimal tomographic image. It is shown that diffuse fluorescence tomography of the orthotopic pancreas model is feasible, with consideration of confounding fluorescence signals from the multiple organs and tissues surrounding the pancreas. MR-guided diffuse fluorescence tomography will be used to monitor EGF response after photodynamic therapy. Additionally, it provide the opportunity to individualize subsequent therapies based on response to PDT as well as to evaluate the success of combination therapies, such as PDT with chemotherapy, antibody therapy or even radiation.

Portal Annular Pancreas

Science.gov (United States)

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

2014-01-01

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

Assessment of a serum tumour marker for carcinoma of the pancreas: the carbohydrate antigen C.A. 19-9

International Nuclear Information System (INIS)

Vincent, D.; Venot, J.; Catanzano, G.; Clement, M.N.; Piquet, M.F.; Veyriras, E.; Beck, C.

1985-01-01

A radio-immunological assay with monoclonal antibodies was used to measure the C 19-9 antigen in 51 patients to determine its diagnostic value in cancer of the pancreas. The results show that the C 19-9 antigen is a good marker for carcinoma of the pancreas and that it can be commonly used [fr

A COMPARATIVE STUDY OF HUMAN PANCREAS WITH OTHER MAMMALIAN PANCREAS

Directory of Open Access Journals (Sweden)

Jyotsna Bhuyan

2016-09-01

Full Text Available Human pancreas is the largest digestive gland in the body. It has both endocrine and exocrine functions. Pancreas secretes the hormones insulin and glucagon. Insulin keeps the body in euglycaemic state as the main function of insulin is metabolism of carbohydrate. Diabetes is a disease of altered carbohydrate metabolism. At present, pancreatic transplantation is the only definitive therapy that can establish a euglycaemic state. AIM AND OBJECTIVE Keeping the importance of pancreatic hormones in human, the present study was carried out where we compared the pancreatic morphology of human with that of pig and goat in terms of length, breadth and weight. MATERIALS AND METHODS This study was conducted in the Department of Anatomy, Assam Medical College, Dibrugarh. A total of 90 specimens were included in the study and these were obtained from human, pig and goat. The human specimen (30 in number were collected from the Forensic Medicine Department of AMCH after fulfilling the official requirements. The specimen of pig and goat (30 each in number were collected from the local slaughter house after obtaining ethical clearance from the concerned authority. In all specimens, the length, breadth and weight was recorded with the help of measuring tape, vernier callipers and electronic weighing machine. INCLUSION AND EXCLUSION CRITERIA Specimen showing signs of putrefaction, any cut or crush injury and congenital anomalies were excluded from the study. RESULT AND OBSERVATIONS In human, the length of the pancreas ranged from 12.11 to 15.09 cm. Maximum breadth of the human pancreas ranged from 4.03 to 5.12 cm and the weight ranged from 79.13 to 102.22 gram. In goat, the length of the pancreas ranged from 12.43 to 13.79 cm, the breadth ranged from 3.03 to 4.93 cm and the weight ranged from 48.43 to 70.03 gram. In pig, the length of the pancreas ranged from 12.46 to 15.87 cm. Maximum breadth of pig pancreas ranged from 3.76 to 4.78 cm and the weight ranged

Clinicopathologic assessment of pancreatic ductal carcinoma located at the head of the pancreas, in relation to embryonic development.

Science.gov (United States)

Okamura, Yukiyasu; Fujii, Tsutomu; Kanzaki, Akiyuki; Yamada, Suguru; Sugimoto, Hiroyuki; Nomoto, Shuji; Takeda, Shin; Nakao, Akimasa

2012-05-01

Pancreaticoduodenectomy is performed for pancreatic head cancer that originated from the dorsal or ventral primordium. Although the extent of lymph node (LN) dissection is the same irrespective of the origin, the lymphatic continuities may differ between the 2 primordia. Between March 2003 and September 2010, 152 patients underwent pancreaticoduodenectomy for pancreatic cancer. One hundred six patients were assigned into 2 groups according to tumor location on preoperative computed tomography, and their clinical and pathological features were retrospectively analyzed in view of the embryonic development of the pancreas. Sixty of 106 patients were classified with tumors that were derived from the dorsal pancreas (D group) and 46 from the ventral pancreas (V group). The frequency of LN involvement around the middle colic artery (LN 15) in the D group was higher than in the V group (P = 0.008). The rate of additional resection of the pancreas tended to be higher in the D group (P = 0.067). The present study showed the detailed pattern of spread of pancreatic ductal carcinoma to the LNs and provided important information for determining the optimal surgical strategy.

Functional imaging of the pancreas

International Nuclear Information System (INIS)

Nakanishi, Fumiko

1984-01-01

An image processing technique for functional imaging of the pancreas was developed and is here reported. In this paper, clinical efficacy of the technique for detecting pancreatic abnormality is evaluated in comparison with conventional pancreatic scintigraphy and CT. For quantitative evaluation, functional rate, i.e. the rate of normal functioning pancreatic area, was calculated from the functional image and subtraction image. Two hundred and ninety-five cases were studied using this technique. Conventional image had a sensitivity of 65 % and a specificity of 78 %, while the use of functional imaging improved sensitivity to 88 % and specificity to 88 %. The mean functional rate in patients with pancreatic disease was significantly lower (33.3+-24.5 in patients with chronic pancreatitis, 28.1+-26.9 in patients with acute pancreatitis, 43.4+-22.3 in patients with diabetes mellitus, 20.4+-23.4 in patients with pancreatic cancer) than the mean functional rate in cases without pancreatic disease (86.4+-14.2). It is suggested that functional image of the pancreas reflecting pancreatic exocrine function and functional rate is a useful indicator of pancreatic exocrine function. (author)

Quality assessments for cancer centers in the European Union.

Science.gov (United States)

Wind, Anke; Rajan, Abinaya; van Harten, Wim H

2016-09-07

Cancer centers are pressured to deliver high-quality services that can be measured and improved, which has led to an increase of assessments in many countries. A critical area of quality improvement is to improve patient outcome. An overview of existing assessments can help stakeholders (e.g., healthcare professionals, managers and policy makers) improve the quality of cancer research and care and lead to patient benefits. This paper presents key aspects of assessments undertaken by European cancer centers, such as: are assessments mandatory or voluntary? Do they focus on evaluating research, care or both? And are they international or national? A survey was sent to 33 cancer centers in 28 European Union member states. Participants were asked to score the specifics for each assessment that they listed. Based on the responses from 19 cancer centers from 18 member states, we found 109 assessments. The numbers have steadily increased from 1990's till 2015. Although, a majority of assessments are on patient-care aspects (n = 45), it is unclear how many of those include assessing patient benefits. Only few assessments cover basic research. There is an increasing trend towards mixed assessments (i.e., combining research and patient-care aspects) The need for assessments in cancer centers is increasing. To improve efforts in the quality of research and patient care and to prevent new assessments that "reinvent the wheel", it is advised to start comparative research into the assessments that are likely to bring patient benefits and improve patient outcome. Do assessments provide consistent and reliable information that create added value for all key stakeholders?

CT diagnosis of annular pancreas

International Nuclear Information System (INIS)

Ueno, Eiko; Isobe, Yoshinori; Niimi, Akiko; Shimizu, Yasushi; Yamada, Akiyoshi; Hanyu, Fujio

1987-01-01

CT scan was performed in two cases of annular pancreas which could be found in one case preoperatively and in the other case retrospectively. CT scan demonstrated secondary changes of annular pancreas such as medial displacement and dilatation of the duodenal bulb in the former case and stenosis of the duodenal loop and thickened soft tissue density around the narrow segment of the duodenal loop in the latter case, although it failed to demonstrate the peninsular protrusion of the parenchyma of the pancreas head. These findings suggest high possibility of diagnosing annular pancreas by CT scan. (author)

Australia and New Zealand Islets and Pancreas Transplant Registry Annual Report 2017—Pancreas Waiting List, Recipients, and Donors

Science.gov (United States)

Webster, Angela C; Hedley, James; Patekar, Abhijit; Robertson, Paul; Kelly, Patrick J

2017-01-01

Abstract This is a registry report from the Australia and New Zealand Islet and Pancreas Transplant Registry. We report data for all solid organ pancreas transplant activity from inception in 1984 to end of 2016. Data analysis was performed using Stata Software version 14 (StataCorp, College Station, Tex). From 1984 to 2016 a total of 756 solid organ pancreas transplants have been performed in Australia and New Zealand, in 738 individuals. In 2016, 55 people received a pancreas transplant. These transplants were performed in Auckland (4), Monash (22), and Westmead (29). In 2016, 50 transplants were simultaneous pancreas kidney, 4 were pancreas after kidney, and 1 was a pancreas transplant alone. PMID:29026874

Towards dense volumetric pancreas segmentation in CT using 3D fully convolutional networks

Science.gov (United States)

Roth, Holger; Oda, Masahiro; Shimizu, Natsuki; Oda, Hirohisa; Hayashi, Yuichiro; Kitasaka, Takayuki; Fujiwara, Michitaka; Misawa, Kazunari; Mori, Kensaku

2018-03-01

Pancreas segmentation in computed tomography imaging has been historically difficult for automated methods because of the large shape and size variations between patients. In this work, we describe a custom-build 3D fully convolutional network (FCN) that can process a 3D image including the whole pancreas and produce an automatic segmentation. We investigate two variations of the 3D FCN architecture; one with concatenation and one with summation skip connections to the decoder part of the network. We evaluate our methods on a dataset from a clinical trial with gastric cancer patients, including 147 contrast enhanced abdominal CT scans acquired in the portal venous phase. Using the summation architecture, we achieve an average Dice score of 89.7 +/- 3.8 (range [79.8, 94.8])% in testing, achieving the new state-of-the-art performance in pancreas segmentation on this dataset.

Increased pancreatic cancer risk following radiotherapy for testicular cancer.

Science.gov (United States)

Hauptmann, Michael; Børge Johannesen, Tom; Gilbert, Ethel S; Stovall, Marilyn; van Leeuwen, Flora E; Rajaraman, Preetha; Smith, Susan A; Weathers, Rita E; Aleman, Berthe M P; Andersson, Michael; Curtis, Rochelle E; Dores, Graça M; Fraumeni, Joseph F; Hall, Per; Holowaty, Eric J; Joensuu, Heikki; Kaijser, Magnus; Kleinerman, Ruth A; Langmark, Frøydis; Lynch, Charles F; Pukkala, Eero; Storm, Hans H; Vaalavirta, Leila; van den Belt-Dusebout, Alexandra W; Morton, Lindsay M; Fossa, Sophie D; Travis, Lois B

2016-09-27

Pancreatic cancer risk is elevated among testicular cancer (TC) survivors. However, the roles of specific treatments are unclear. Among 23 982 5-year TC survivors diagnosed during 1947-1991, doses from radiotherapy to the pancreas were estimated for 80 pancreatic cancer patients and 145 matched controls. Chemotherapy details were recorded. Logistic regression was used to estimate odds ratios (ORs). Cumulative incidence of second primary pancreatic cancer was 1.1% at 30 years after TC diagnosis. Radiotherapy (72 (90%) cases and 115 (80%) controls) was associated with a 2.9-fold (95% confidence interval (CI) 1.0-7.8) increased risk. The OR increased linearly by 0.12 per Gy to the pancreas (P-trendcancer risk, and persists for over 20 years. These excesses, although small, should be considered when radiotherapy with exposure to the pancreas is considered for newly diagnosed patients. Additional data are needed on the role of chemotherapy.

Combination of chemotherapy and heavy-ion particle therapy for gastrointestinal cancer

International Nuclear Information System (INIS)

Yamada, Shigeru; Kitabayashi, Hiroyuki; Furusawa, Yoshiya; Ando, Koichi

2005-01-01

The purpose of this study is to investigate the combination of chemotherapy and heavy-ion particle therapy for pancreas and esophageal cancer. We measured surviving fractions in four culture pancreas and esophageal cancer cells. The cell killing of heavy-ion irradiation is more effective compared to that of X ray irradiation. Gemcitabine induced radiosensitization for pancreas cancer cells and also taxotel for esophageal cancer. (author)

Diagnostic imaging of the pancreas

International Nuclear Information System (INIS)

Araki, Tsutomu; Itai, Yuji

1981-01-01

Diagnostic imaging of the pancreas, ultrasonography (US), computed tomography (CT), radionuclide (RN) scintigraphy, angiography, and endoscopic retrograde pancreaticography (ERP). First three noninvasive methods, were the most effective to diagnose psudo-cyst or cystoadenoma. Especially, CT gives the clear image of inflammation and shows pancreatic stones and calcification, with high sensitivity. As for pancreatic carcinomas there was no noninvasive methods to apply at an early stage. In order to diagnose the cancer the combination of angiography and ERP was preferable. The problem was how to select the candidates for the investigation of combined method out of the patients with negative CT or US. (Tsunoda, M.)

Malignant Nonfunctioning Neuroendocrine Neoplasm of the Pancreas in a 10-Year-Old Child

Directory of Open Access Journals (Sweden)

Ahmed Marwan

2009-04-01

Full Text Available Malignant neoplasms of the pancreas are extremely rare in children and only represent a small percentage of pediatric cancer-related deaths. The paucity of cases reported in the literature, in addition to the lack of understanding of biologic behavior, has led to a lack of consensus concerning optimal management strategy. Presentation differs compared to adult counterparts and generally prognosis is improved even when lymph node metastases occur. Here we review the literature and report the case of a 10-year-old autistic female with a malignant nonfunctioning pancreatic endocrine neoplasm of the head of the pancreas successfully extirpated via pancreaticoduodenectomy.

The pancreas from Aristotle to Galen.

Science.gov (United States)

Tsuchiya, Ryoichi; Kuroki, Tamotsu; Eguchi, Susumu

2015-01-01

The first description of the pancreas in literature is found in Aristotle's Historia Animalium, but it is modified by "so-called". Therefore, the origin is pursued more extensively. The Greek-English Lexicon recommends three treatises as a possible original source. These three and Galen's other papers are investigated. In 2005, Sachs et al. suggested an origin of the pancreas might have derived from the intestinal divination using the avian pancreas. This report is evaluated. The avian pancreas which is the intraperitoneal organ, might have been well known by the intestinal divination, and people have called the organ pankreas or kallikreas. Anatomical dissection on human body was not accepted before the Aristotle's time. "So-called pancreas" in Historia must have been interpolated by Theophrastus. He was the most faithful and reliable disciple of Aristotle and succeeded the Aristotle's school. He and Macedonian ruler of Egypt Ptolemy I had known each other and there had been a strong link between them. The contemporary Herophilus performed many public dissections on both human and animal bodies in Alexandria. He named the various parts of the human body and designated the beginning intestine as duodenum. Yet in his extant works, the pancreas is not found. It is surmised that Herophilus may be the first to recognize the human pancreas, which is fixed with retroperitoneal tissue, and he named it "so-called pancreas". Theophrastus might have interpolated Herophilus' designation in Historia Animalium. Galen also uses "so-called pancreas" to designate the human pancreas. Galen's descriptions, that is, "Nature created 'so-called pancreas 'and spread it beneath all vessels" are not generally acceptable but propose the very rare portal vein anomalies. Since the early years of the 20th century, cases with a preduodenal portal vein or a prepancreatic portal vein have been reported. Although the incidence is very rare, its surgical importance is emphasized. Copyright © 2014

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

International Nuclear Information System (INIS)

Yamamoto, Kaoru; Miyatsuka, Takeshi; Tanaka, Ayako; Toyoda, Shuichi; Kato, Ken; Shiraiwa, Toshihiko; Fujitani, Yoshio; Yamasaki, Yoshimitsu; Hori, Masatsugu; Matsuhisa, Munehide; Matsuoka, Taka-aki; Kaneto, Hideaki

2007-01-01

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 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 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 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

Serous cystadenocarcinoma of pancreas

International Nuclear Information System (INIS)

Rathore, M. U.; Arif, A.; Umair, B.

2013-01-01

Serous cystic neoplasms of pancreas are relatively rare tumours. Malignancy in these tumours is even more rare which is confirmed by metastasis to other organs or by perineural, vascular or surrounding soft tissue invasion. A 60 years old lady presented with vague upper abdominal pain. Computed tomography scan showed multiloculated cystic mass in the body of pancreas measuring 9 x 6 x 5 cm and not involving spleen. Pancreatectomy specimen showed a multicystic tumour having sponge-like appearance which showed vascular and soft tissue invasion of surrounding stroma on microscopic examination and was diagnosed as serous cystadenocarcinoma of pancreas. (author)

Invitation strategies and coverage in the population-based cancer screening programmes in the European Union.

Science.gov (United States)

Vale, Diama B; Anttila, Ahti; Ponti, Antonio; Senore, Carlo; Sankaranaryanan, Rengaswamy; Ronco, Guglielmo; Segnan, Nereo; Tomatis, Mariano; Žakelj, Maja P; Elfström, Klara M; Lönnberg, Stefan; Dillner, Joakim; Basu, Partha

2018-03-21

The aim of this study was to describe the compliance of the population-based cancer screening programmes in the European Union Member States to the invitation strategies enumerated in the European Guidelines and the impact of such strategies on the invitational coverage. Experts in screening programme monitoring from the respective countries provided data. Coverage by invitation was calculated as the proportion of individuals in the target age range receiving a screening invitation over the total number of annualized eligible population. The invitation strategies of 30 breasts, 25 cervical and 27 colorectal national or regional population-based screening programmes are described. Individual mail invitations are sent by 28 breasts, 20 cervical and 25 colorectal screening programmes. Faecal occult blood test kits are sent by post in 17 of the colorectal cancer screening programmes. The majority of programmes claimed to have a population registry, although some use health insurance data as the database for sending invitations. At least 95% invitation coverage was reached by 16 breast, six cervical and five colorectal screening programmes. Majority of the programmes comply with the invitation strategies enumerated in the European guidelines, although there is still scope for improvements. Coverage by invitation is below the desirable level in many population-based cancer screening programmes in European Union.

Acid-base transport in pancreas – new challenges

Directory of Open Access Journals (Sweden)

Ivana eNovak

2013-12-01

Full Text Available Along the gastrointestinal tract a number of epithelia contribute with acid or basic secretions in order to aid digestive processes. The stomach and pancreas are the most extreme examples of acid (H+ and base (HCO3- transporters, respectively. Nevertheless, they share the same challenges of transporting acid and bases across epithelia and effectively regulating their intracellular pH. In this review, we will make use of comparative physiology to enlighten the cellular mechanisms of pancreatic HCO3- and fluid secretion, which is still challenging physiologists. Some of the novel transporters to consider in pancreas are the proton pumps (H+-K+-ATPases, as well as the calcium-activated K+ and Cl- channels, such as KCa3.1 and TMEM16A/ANO1. Local regulators, such as purinergic signalling, fine-tune and coordinate pancreatic secretion. Lastly, we speculate whether dys-regulation of acid-base transport contributes to pancreatic diseases including cystic fibrosis, pancreatitis and cancer.

Malignant neoplasms of the pancreas, liver, and biliary tract

International Nuclear Information System (INIS)

Lawson, T.L.; Berland, L.L.; Foley, W.D.

1985-01-01

Ductal adenocarcinoma of the pancreas is of increasing medical importance in the United States. The age-adjusted mortality rate has risen from 2.9 to 9.0 per 100,000 population between the years 1920 and 1970. This represents an increase of over 300%. Since the mean survival from time of diagnosis is only 4.3 months, the mortality and incidence rates essentially are equal. Pancreatic carcinoma now accounts for 3% of all cancers and 5% of all cancer deaths in the United States. It is the fourth most common cause of death from cancer in men and the fifth most common in women. Despite advances in chemotherapy and radiation therapy, these modalities are primarily palliative and have not been shown to alter survival significantly

Assessment of pancreas cells

Science.gov (United States)

Vanoss, C. J.

1978-01-01

Pancreatic islets were obtained from guinea pig pancreas by the collagenase method and kept alive in tissue culture prior to further studies. Pancreas cell morphology was studied by standard histochemical techniques using light microscopy. Preparative vertical electrophoresis-levitation of dispersed fetal guinea pig pancreas cells was conducted in phosphate buffer containing a heavy water (D20) gradient which does not cause clumping of cells or alter the osmolarity of the buffers. The faster migrating fractions tended to be enriched in beta-cell content. Alpha and delta cells were found to some degree in most fractions. A histogram showing the cell count distribution is included.

Radiology of the pancreas

International Nuclear Information System (INIS)

Baert, A.L.; Delorme, G.

1994-01-01

This book, written by internationally recognized experts, fully illustrates the diagnosis of both common and rarer diseases of the pancreas, the latest technical developments in relevant imaging modalities are thoroughly discussed and appraised with respect to the pancreas. The book will appeal to both clinicians and researchers in radiology and oncology. (orig.)

Genetics Home Reference: Pearson marrow-pancreas syndrome

Science.gov (United States)

... Health Conditions Pearson marrow-pancreas syndrome Pearson marrow-pancreas syndrome Printable PDF Open All Close All Enable ... view the expand/collapse boxes. Description Pearson marrow-pancreas syndrome is a severe disorder that usually begins ...

Endoscopic ultrasound and pancreas divisum

DEFF Research Database (Denmark)

Rana, Surinder S; Gonen, Can; Vilmann, Peter

2012-01-01

Pancreas divisum is the most common congenital anatomic variation of the pancreatic ductal anatomy and in most of the individuals it is asymptomatic. However, in minority of individuals it is presumed to cause recurrent acute pancreatitis and chronic pancreatitis. Endoscopic retrograde cholangiop......Pancreas divisum is the most common congenital anatomic variation of the pancreatic ductal anatomy and in most of the individuals it is asymptomatic. However, in minority of individuals it is presumed to cause recurrent acute pancreatitis and chronic pancreatitis. Endoscopic retrograde...... of the parenchyma also. Therefore EUS, both radial and linear, has potential for being a minimally invasive diagnostic modality for pancreas divisum. A number of EUS criteria have been suggested for the diagnosis of pancreas divisum. These criteria have varying sensitivity and specificity and hence there is a need...

Simultaneous Kidney-Pancreas Transplantation With an Original "Transverse Pancreas" Technique: Initial 9 Years' Experience With 56 Cases.

Science.gov (United States)

Paulino, J; Martins, A; Vigia, E; Marcelino, P; Nobre, A M; Bicho, L; Filipe, E; Barroso, E

2017-10-01

An innovative technique for pancreas transplantation is described. The main aspect consists of the horizontal positioning of the pancreas, which allows a better venous outflow, thus preventing thrombosis and graft loss. The program of pancreas transplantation in this national reference center for pancreatic and liver surgery was started in 2007; the initial results were considered poor, resulting in the loss of half of the grafts due to venous thrombosis. After analyzing the possible causes, this technique was proposed and successfully implemented, reducing the postoperative complications, particularly the problem of venous thrombosis. A detailed description of the new surgical technique is provided. The main clinical and demographic characteristics of the 56 patients who underwent the surgery are analyzed. The incidence of venous thrombosis was 5.3% (3 patients) and graft loss was 3.5% (2 patients). Due to the good results, this technique became the standard surgery for transplantation of the pancreas in our center. The technique proved to be safe and successful. Due to the unique pancreas graft implantation, we called it "transverse pancreas surgery." Copyright © 2017 Elsevier Inc. All rights reserved.

Laparoscopic robot-assisted pancreas transplantation: first world experience.

Science.gov (United States)

Boggi, Ugo; Signori, Stefano; Vistoli, Fabio; D'Imporzano, Simone; Amorese, Gabriella; Consani, Giovanni; Guarracino, Fabio; Marchetti, Piero; Focosi, Daniele; Mosca, Franco

2012-01-27

Surgical complications are a major disincentive to pancreas transplantation, despite the undisputed benefits of restored insulin independence. The da Vinci surgical system, a computer-assisted electromechanical device, provides the unique opportunity to test whether laparoscopy can reduce the morbidity of pancreas transplantation. Pancreas transplantation was performed by robot-assisted laparoscopy in three patients. The first patient received a pancreas after kidney transplant, the second a simultaneous pancreas kidney transplantation, and the third a pancreas transplant alone. Operations were carried out through an 11-mm optic port, two 8-mm operative ports, and a 7-cm midline incision. The latter was used to introduce the grafts, enable vascular cross-clamping, and create exocrine drainage into the jejunum. The two solitary pancreas transplants required an operating time of 3 and 5 hr, respectively; the simultaneous pancreas kidney transplantation took 8 hr. Mean warm ischemia time of the pancreas graft was 34 min. All pancreatic transplants functioned immediately, and all recipients became insulin independent. The kidney graft, revascularized after 35 min of warm ischemia, also functioned immediately. No patient had complications during or after surgery. At the longer follow-up of 10, 8, and 6 months, respectively, all recipients are alive with normal graft function. We have shown the feasibility of laparoscopic robot-assisted solitary pancreas and simultaneous pancreas and kidney transplantation. If the safety and feasibility of this procedure can be confirmed by larger series, laparoscopic robot-assisted pancreas transplantation could become a new option for diabetic patients needing beta-cell replacement.

Method of pancreas scintigraphy

International Nuclear Information System (INIS)

Michele, E.; Schmidt, H.A.E.

1976-01-01

Scintigraphy of the pancreas is important because of a lack of simple internal and x-ray pancreas diagnostic examination methods, non-burdening to the patient, yet providing sufficient evidence. We conceived a double isotope subtraction method aimed at widespread application; financially, it should be within the range even of smaller nuclear medicine departments. A scanner is combined with double impulse processing and a subtraction unit (Picker Dualscanner) and an adapted x-ray unit with the x-ray tube aimed at the scan-field. Commercial sup(Se-75)selenium methionine is used for pancreas imagining. sup(TC-99m)colloidal sulphur is used as a liver indicator. After barium-brei application orally, an x-ray is taken of the gastro-intestinal tract, so as to be able to delineate the pancreas from other epigastric organs also able to accumulate methionine. The subtraction photoscan is then inscribed on this pre-exposed film without any shift of the patient. It is also possible to use two parallel films (x-ray/photoscan) and then to superposition them

Computed tomography of the pancreas and gallbladder

International Nuclear Information System (INIS)

Onizuka, Hideo; Matsuura, Keiichi

1982-01-01

The authors viewed the present status of CT diagnosis in pancreatic and biliary diseases, referring to its future. CT imaged neither normal intrahepatic biliary ducts nor normal pancreatic ducts because of a relatively low resolution. The accuracy of CT in diagnosing obstructive jaundice has been 85 - 100%. CT showed a higher reproducibility than that of ultrasound in follow-up of intrahepatic gallstones. On the other hand, ultrasound was superior to CT in detecting gallstones. Diagnosis of cholecystitis by CT was usually impossible. Detecting early stage of gallbladder cancer by CT is very rarely, but it was of value for investigating the extent of advanced cancers. This tendency was also observed in biliary duct carcinoma, acute and chronic pancreatitis, and carcinoma of the pancreas. Consequently, it was concluded that CT is not appropriate for the purpose of early detection of pancreatic and other cancers. The use of CT with NMR is expected in future. (Ueda, J.)

Intraductal papillary-mucinous neoplasia of the pancreas: Histopathology and molecular biology.

Science.gov (United States)

Verbeke, Caroline S

2010-10-27

Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is a clinically and morphologically distinctive precursor lesion of pancreatic cancer, characterized by gradual progression through a sequence of neoplastic changes. Based on the nature of the constituting neoplastic epithelium, degree of dysplasia and location within the pancreatic duct system, IPMNs are divided in several types which differ in their biological properties and clinical outcome. Molecular analysis and recent animal studies suggest that IPMNs develop in the context of a field-defect and reveal their possible relationship with other neoplastic precursor lesions of pancreatic cancer.

Pancreas preserving total duodenectomy for complex duodenal injury.

Science.gov (United States)

Wig, Jai Dev; Kudari, Ashwinikumar; Yadav, Thakur Deen; Doley, Rudra Prasad; Bharathy, Kishore Gurumoorthy Subramanya; Kalra, Naveen

2009-07-06

To assess the feasibility and safety of a pancreas-preserving total duodenectomy in the management of severe duodenal injury caused by abdominal trauma. Two patients with both extensive injury of the duodenum and diffuse peritonitis underwent pancreas preserving total duodenectomy at our tertiary care centre. These two young male patients (age 20 and 22 years) presented 2 days and 6 hours respectively following blunt abdominal trauma. The duodenum was almost completely separated from the pancreas. Ampulla was seen as a button on the pancreas. Following total duodenectomy, reconstruction was performed by suturing the jejunum to the head of the pancreas anteriorly and posteriorly away from the ampulla (invagination of the pancreas into the jejunum). There were no complications attributable to the procedure. Both patients are well on follow up. A Pancreas-preserving total duodenectomy offers a safe alternative to the Whipple procedure in managing complex duodenal injury. This procedure avoids unnecessary resection of the adjacent pancreas and anastomosis to undilated hepatic and pancreatic ducts.

Clinical evaluation of computed tomography of the pancreas

International Nuclear Information System (INIS)

Miura, Takashi; Nakao, Morio; Takayasu, Yukio; Inamoto, Kazuo; Yamazaki, Hideo

1980-01-01

The pancreas was observed from many directions on conventional CT images and reconstructed coronal and sagittal tomograms. Absorbed values of x-ray in the pancreas were also counted by setting ROI on conventional CT images. The subjects were 37 patients with pancreatic diseases or normal pancreas. Equipments used were Somatom SD and Evaluskop for analysis of images. Slice width and feed for reconstruction of CT images were 4 mm and 3 mm, respectively. Absorbed values of x-ray was significantly lower in patients with pancreatic carcinoma than in patients with normal pancreas. Slightly low absorbed values of x-ray in pancreas tail could suggest small carcinoma of pancreas even when CT images could not visualize it clearly. There was not a significant difference in absorbed values between chronic pancreatitis and normal pancreas, but their variations were big. Observation of the pancreas from many directions on reconstructed CT images were very useful for the diagnosis of pancreatic diseases. (Tsunoda, M.)

The Dutch Pancreas Biobank Within the Parelsnoer Institute: A Nationwide Biobank of Pancreatic and Periampullary Diseases.

Science.gov (United States)

Strijker, Marin; Gerritsen, Arja; van Hilst, Jony; Bijlsma, Maarten F; Bonsing, Bert A; Brosens, Lodewijk A; Bruno, Marco J; van Dam, Ronald M; Dijk, Frederike; van Eijck, Casper H; Farina Sarasqueta, Arantza; Fockens, Paul; Gerhards, Michael F; Groot Koerkamp, Bas; van der Harst, Erwin; de Hingh, Ignace H; van Hooft, Jeanin E; Huysentruyt, Clément J; Kazemier, Geert; Klaase, Joost M; van Laarhoven, Cornelis J; van Laarhoven, Hanneke W; Liem, Mike S; de Meijer, Vincent E; van Rijssen, L Bengt; van Santvoort, Hjalmar C; Suker, Mustafa; Verhagen, Judith H; Verheij, Joanne; Verspaget, Hein W; Wennink, Roos A; Wilmink, Johanna W; Molenaar, I Quintus; Boermeester, Marja A; Busch, Olivier R; Besselink, Marc G

2018-04-01

Large biobanks with uniform collection of biomaterials and associated clinical data are essential for translational research. The Netherlands has traditionally been well organized in multicenter clinical research on pancreatic diseases, including the nationwide multidisciplinary Dutch Pancreatic Cancer Group and Dutch Pancreatitis Study Group. To enable high-quality translational research on pancreatic and periampullary diseases, these groups established the Dutch Pancreas Biobank. The Dutch Pancreas Biobank is part of the Parelsnoer Institute and involves all 8 Dutch university medical centers and 5 nonacademic hospitals. Adult patients undergoing pancreatic surgery (all indications) are eligible for inclusion. Preoperative blood samples, tumor tissue from resected specimens, pancreatic cyst fluid, and follow-up blood samples are collected. Clinical parameters are collected in conjunction with the mandatory Dutch Pancreatic Cancer Audit. Between January 2015 and May 2017, 488 patients were included in the first 5 participating centers: 4 university medical centers and 1 nonacademic hospital. Over 2500 samples were collected: 1308 preoperative blood samples, 864 tissue samples, and 366 follow-up blood samples. Prospective collection of biomaterials and associated clinical data has started in the Dutch Pancreas Biobank. Subsequent translational research will aim to improve treatment decisions based on disease characteristics.

MR imaging of pancreas in cystic fibrosis

International Nuclear Information System (INIS)

Murayama, S.; Robinson, A.E.; Mulvihill, D.M.; Stallworth, J.M.; Goyco, P.G.; Beckerman, R.C.; Hines, M.R.

1990-01-01

The pancreatic regions of 18 patients with cystic fibrosis were analyzed with a 1.5 Tesla MR unit. Signal intensity of the pancreas was correlated with clinical data and ultrasound. A hyperintense pancreas on T1-weighted image was consistent with fatty replacement of pancreatic insufficiency. A pancreas of normal soft tissue intensity was found in two asymptomatic and one symptomatic patient. A very hypointense pancreas on any pulse sequence was considered to be an intermediate stage of pancreatic degeneration. (orig.)

Comparative functional scintigraphic and angiographic examination in pancreas diseases

International Nuclear Information System (INIS)

Mendizov, A.; Brilski, V.; Bozhiyanov, A.; Romanova, A.; Mardzhanov, I.; Glavincheva, I.; Meditsinska Akademiya, Sofia

1979-01-01

Pancreas scintigraphy with 75 seleno-methionine, pancreocimine-secretine test and selective abdominal angiography was carried out in patients with chronic pancreatitis, pancreas carcinoma and subjects without any pancreas diseases. Scintigraphic changes in pancreas was found in 95,6 per cent of the patients with chronic pancreatitis (136 patients), in 92 per cent of them with pancreas carcinoma (25 patients) and in 53,4 per cent from the subjects without pancreas diseases (30 examined). Pathological changes in pancreatic secretion was found in 93,4 per cent of the patients with chronic pancreatitis (105 patients), in 93,8 per cent of the subjects with pancreas carcinoma (32 patients) and only in 3,9 per cent from the examined without pancreatic diseases. The angiographic examination is informative mainly in case of tumours and cysts of the pancreas. The diagnostic potentialities of the separate methods for pancreas examination were critically assessed. The basic diagnostic problems in pancreas diseases are solved to a great extent with the combined examination with scintigraphy pancreocimine test and angiography (76 patients). (author)

A rare case of sarcomatoid carcinoma of the pancreas associated with pancreatolithiasis

Directory of Open Access Journals (Sweden)

Rashid MM

2013-01-01

Full Text Available Pancreatolithiasis is a risk factor for developing pancreatic cancer. We report here a rare case of sarcomatoid carcinoma of the pancreas in a 55-year old diabetic male associated with pancreatolithiasis. CT scan of abdomen revealed a large operable mass occupying the distal body and tail of the pancreas. Per-operative survey revealed a small metastatic nodule in the surface of hepatic segment IVa. Histopathology of the distal pancreatic lesion revealed sarcomatoid carcinoma. Hepatic nodule was a metastatic adenocarcinoma. Distal pancreatectomy and splenectomy was done en-mass, along with non-anatomical resection of the hepatic metastatic nodule. Combined with six cycles of chemotherapy, the patient survived a total of another fourteen months. Ibrahim Med. Coll. J. 2013; 7(1: 12-15

Adenocarcinoma arising in a heterotopic pancreas (Heinrich type III: a case report

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Egashira Yutaro

2010-02-01

Full Text Available Abstract Introduction Heterotopic pancreatic cancer in the duodenum is a very rare disease. Only twelve cases have been reported worldwide to date. We report a rare case of malignant transformation of heterotopic pancreas (Heinrich type III in the duodenum with long-term survival of the patient, and review the 12 cases in the literature. Case presentation A 75-year-old Japanese man was admitted to our hospital complaining of nausea and vomiting. Endoscopy and upper gastrointestinal contrast study showed marked duodenal stenosis. A pylorus-preserving pancreaticoduodenectomy was performed. Histopathological examination of the surgically resected specimen showed malignant transformation of heterotopic pancreas (Heinrich type III in the duodenum. The postoperative course was uneventful, and the patient was discharged from the hospital on postoperative day 30. He is well and shows no signs of recurrence at the time of writing, six years after the surgery. Conclusion Adenocarcinoma arising within the heterotopic pancreas appears to be rare. It is difficult to obtain a correct diagnosis preoperatively. The management of heterotopic pancreas depends on the presence or absence of symptoms. If the patient is asymptomatic or benign, conservative treatment with regular follow-up is recommended. When the patient is symptomatic or there is a suspicion of malignancy, surgical management with intra-operative frozen section diagnosis is indicated.

Pancreas retransplantation: a second chance for diabetic patients?

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Buron, Fanny; Thaunat, Olivier; Demuylder-Mischler, Sandrine; Badet, Lionel; Brunet, Maria; Ber, Charles-Eric; Thivolet, Charles; Martin, Xavier; Berney, Thierry; Morelon, Emmanuel

2013-01-27

If pancreas transplantation is a validated alternative for type 1 diabetic patients with end-stage renal disease, the management of patients who have lost their primary graft is poorly defined. This study aims at evaluating pancreas retransplantation outcome. Between 1976 and 2008, 569 pancreas transplantations were performed in Lyon and Geneva, including 37 second transplantations. Second graft survival was compared with primary graft survival of the same patients and the whole population. Predictive factors of second graft survival were sought. Patient survival and impact on kidney graft function and survival were evaluated. Second pancreas survival of the 17 patients transplanted from 1995 was close to primary graft survival of the whole population (71% vs. 79% at 1 year and 59% vs. 69% at 5 years; P=0.5075) and significantly better than their first pancreas survival (71% vs. 29% at 1 year and 59% vs. 7% at 5 years; P=0.0008) regardless of the cause of first pancreas loss. The same results were observed with all 37 retransplantations. Survival of second simultaneous pancreas and kidney transplantations was better than survival of second pancreas after kidney. Patient survival was excellent (89% at 5 years). Pancreas retransplantation had no impact on kidney graft function and survival (100% at 5 years). Pancreas retransplantation is a safe procedure with acceptable graft survival that should be proposed to diabetic patients who have lost their primary graft.

A Study on Pancreas Scanning with Selenium75-Selenomethionine

International Nuclear Information System (INIS)

Shin, Hyun Chan; Toh, Sang Hee; Ra, Woo Youn; Suh, Chul Sung

1968-01-01

Radiographic visualization of the pancreas is a difficult problem, but the direct visualization of the pancreas is possible by the injection of the amino-acid methionine tagged with selenium 75 (Se 75 ). In order to know the diagnostic value of pancreas scanning, scans were performed on 23 cases using selenium 75 -Selenomethionine. These cases were also given egg white, probanthine and morphine. 1) Good visualization of the pancreas scanning was observed on 19 cases, presumably with normal pancreas. 2) A case which showed diffusely decreased uptake on pancreas scanning was proven to have lesions in the bile duct and the gall bladder. 3) Of those two cases which showed localized cold area, one had pancreas cyst and the other one was not explored. 4) A case which showed no visualization of the pancreas was proven to have pancreatic carcinoma. 5) Two cases which showed widened duodenal loop by upper gastro-intestinal series revealed normal pancreas scanning, and no pancreatic disease was found in both cases.

Computed tomography of the pancreas

International Nuclear Information System (INIS)

Kolmannskog, F.; Kolbenstvedt, A.; Aakhus, T.; Bergan, A.; Fausa, O.; Elgjo, K.

1980-01-01

The findings by computed tomography in 203 cases of suspected pancreatic tumours, pancreatitis or peripancreatic abnormalities were evaluated. The appearances of the normal and the diseased pancreas are described. Computed tomography is highly accurate in detecting pancreatic masses, but can not differentiate neoplastic from inflammatory disease. The only reliable signs of pancreatic carcinoma are a focal mass in the pancreas, together with liver metastasis. When a pancreatic mass is revealed by computed tomography, CT-guided fine-needle aspiration biopsy of the pancreas is recommended. Thus the need for more invasive diagnostic procedures and explorative laparotomy may be avoided in some patients. (Auth.)

Congenital anomalies, hereditary diseases of the pancreas, acute and chronic pancreatitis; Entwicklungsstoerungen, angeborene Erkrankungen des Pankreas, akute und chronische Pankreatitis

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Brambs, Hans-Juergen; Juchems, Markus [Universitaetsklinikum Ulm (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie

2011-06-15

The most important congenital anomalies include pancreas divisum, annular pancreas and ectopic pancreas. Patients with pancreas divisum may be more susceptible to acute or chronic pancreatitis and patients with an annular pancreas may develop duodenal stenosis. In pancreas divisum the key finding is the visualization of the main duct draining into the duodenum via the small papilla, separated from the common bile duct. Annular pancreas may show as a well defined ring of pancreatic tissue that encircles the duodenum. Ectopic pancreas is usually asymptomatic but may give rise to abdominal complaints and may be confused with submucosal tumors. Acute pancreatitis is classified as mild or severe. In mild forms ultrasound is the imaging modality of choice whereas in severe forms with extensive pancreatic and peripancreatic necroses computed tomography is the favored method. It is crucial to identify signs and criteria that come along with an increased risk of infection of the necroses. MRI plays an inferior role in the assessment of acute pancreatitis. Chronic pancreatitis is a longstanding inflammatory and fibrosing process causing pain and loss of function. Cross-section imaging is particularly in demand for the detection of complications and the differentiation from pancreatic cancer. Autoimmune pancreatitis is a unique form of chronic pancreatitis characterized by lymphoplasmacytic infiltration and fibrosis, and favourable response to corticosteroid treatment. (orig.)

A Case of Successful Simultaneous Pancreas-Kidney Transplantation Using the Injured Pancreas Graft.

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Miyagi, S; Shimizu, K; Miyazawa, K; Nakanishi, W; Hara, Y; Tokodai, K; Nakanishi, C; Satomi, S; Goto, M; Unno, M; Kamei, T

2017-12-01

Graft injuries sometimes occur and may cause complications such as the leakage of pancreatic secretions, which is often lethal. We report our experience of a case of successful simultaneous pancreas-kidney transplantation using injured pancreas graft. The recipient was a 57-year-old woman with type 1 diabetes mellitus, and the donor was a 30-year-old man with a brain injury. In the donation, the pancreas parenchyma, splenic artery, and gastroduodenal artery were injured iatrogenically. We therefore reconstructed these arteries using vessel grafts and then performed simultaneous pancreas-kidney transplantation. Five days after transplantation, we noted a high titer of amylase in the ascites; therefore, we performed an urgent laparotomy. The origin of the amylase was the injured pancreatic parenchyma, and continued washing and drainage were carried out. We reconstructed the duodenojejunostomy using the Roux-en-Y technique to separate the passage of food from the pancreas graft to prevent injury to other organs due to exposure to pancreatic secretions. Thereafter, we inserted a decompression tube into the anastomosis thorough the blind end of the jejunum. Finally, we inserted 3 drainage tubes for lavage. Following this procedure, the patient recovered gradually and no longer required hemodialysis and insulin therapy. She was discharged from our hospital 56 days after transplantation. The restoration of the injured graft was possible by management of pancreatic secretions and use of the donor's vessel grafts. Shortage of donors is a problem throughout the world; thus, it is important to use injured grafts for transplantation if possible. Copyright © 2017 Elsevier Inc. All rights reserved.

Pancreas Volume and Fat Deposition in Diabetes and Normal Physiology: Consideration of the Interplay Between Endocrine and Exocrine Pancreas.

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Saisho, Yoshifumi

2016-01-01

The pancreas is comprised of exocrine and endocrine components. Despite the fact that they are derived from a common origin in utero, these two compartments are often studied individually because of the different roles and functions of the exocrine and endocrine pancreas. Recent studies have shown that not only type 1 diabetes (T1D), but also type 2 diabetes (T2D), is characterized by a deficit in beta-cell mass, suggesting that pathological changes in the pancreas are critical events in the natural history of diabetes. In both patients with T1D and those with T2D, pancreas mass and exocrine function have been reported to be reduced. On the other hand, pancreas volume and pancreatic fat increase with obesity. Increased beta-cell mass with increasing obesity has also been observed in humans, and ectopic fat deposits in the pancreas have been reported to cause beta-cell dysfunction. Moreover, neogenesis and transdifferentiation from the exocrine to the endocrine compartment in the postnatal period are regarded as a source of newly formed beta-cells. These findings suggest that there is important interplay between the endocrine and exocrine pancreas throughout life. This review summarizes the current knowledge on physiological and pathological changes in the exocrine and endocrine pancreas (i.e., beta-cell mass), and discusses the potential mechanisms of the interplay between the two compartments in humans to understand the pathophysiology of diabetes better.

Pancreas Volume and Fat Deposition in Diabetes and Normal Physiology: Consideration of the Interplay Between Endocrine and Exocrine Pancreas

Science.gov (United States)

Saisho, Yoshifumi

2016-01-01

The pancreas is comprised of exocrine and endocrine components. Despite the fact that they are derived from a common origin in utero, these two compartments are often studied individually because of the different roles and functions of the exocrine and endocrine pancreas. Recent studies have shown that not only type 1 diabetes (T1D), but also type 2 diabetes (T2D), is characterized by a deficit in beta-cell mass, suggesting that pathological changes in the pancreas are critical events in the natural history of diabetes. In both patients with T1D and those with T2D, pancreas mass and exocrine function have been reported to be reduced. On the other hand, pancreas volume and pancreatic fat increase with obesity. Increased beta-cell mass with increasing obesity has also been observed in humans, and ectopic fat deposits in the pancreas have been reported to cause beta-cell dysfunction. Moreover, neogenesis and transdifferentiation from the exocrine to the endocrine compartment in the postnatal period are regarded as a source of newly formed beta-cells. These findings suggest that there is important interplay between the endocrine and exocrine pancreas throughout life. This review summarizes the current knowledge on physiological and pathological changes in the exocrine and endocrine pancreas (i.e., beta-cell mass), and discusses the potential mechanisms of the interplay between the two compartments in humans to understand the pathophysiology of diabetes better. PMID:28012279

Laparoscopic removal of a needle from the pancreas

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Amit Jain

2013-01-01

Full Text Available Foreign bodies inside the pancreas are rare and usually occur after the ingestion of sharp objects like fish bone, sewing needle and toothpick. Most of the ingested foreign bodies pass spontaneously through the anus without being noticed but about 1% of them can perforate through the wall of stomach or duodenum to reach solid organs like pancreas or liver. Once inside the pancreas they can produce complications like abscess, pseudoaneurysm or pancreatits. Foreign bodies of pancreas should be removed by endoscopic or surgical methods. We hereby report our experience of successful removal one a sewing needle from pancreas.

Feasibility and safety of electrochemotherapy (ECT) in the pancreas: a pre-clinical investigation

International Nuclear Information System (INIS)

Girelli, Roberto; Prejanò, Simona; Cataldo, Ivana; Corbo, Vincenzo; Martini, Lucia; Scarpa, Aldo; Claudio, Bassi

2015-01-01

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease generally refractory to standard chemotherapeutic agents; therefore improvements in anticancer therapies are mandatory. A major determinant of therapeutic resistance in PDAC is the poor drug delivery to neoplastic cells, mainly due to an extensive fibrotic reaction. Electroporation can be used in vivo to increase cancer cells’ local uptake of chemotherapeutics (electrochemotherapy, ECT), thus leading to an enhanced tumour response rate. In the present study, we evaluated the in vivo effects of reversible electroporation in normal pancreas in a rabbit experimental model. We also tested the effect of electroporation on pancreatic cancer cell lines in order to evaluate their increased sensitivity to chemotherapeutic agents. The application in vivo of the European Standard Operating Procedure of Electrochemotherapy (ESOPE) pulse protocol (1000 V/cm, 8 pulses, 100 μs, 5 KHz) was tested on the pancreas of normal New Zealand White Rabbits and short and long-term toxicity were assessed. PANC1 and MiaPaCa2 cell lines were tested for in vitro electrochemotherapy experiments with and without electroporation. Levels of cell permeabilization were determined by flow cytometry, whereas cell viability and drug (cisplatin and bleomycin) sensitivity of pulsed cells were measured by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl) -2H-tetrazolium (MTS) assay. In healthy rabbits, neither systemic nor local toxic effects due to the electroporation procedure were observed, demonstrating the safety of the optimized electric parameters in the treatment of the pancreas in vivo. In parallel, we established an optimized protocol for ECT in vitro that determined an enhanced anti-cancer effect of bleomycin and cisplatin with respect to treatment without electroporation. Our data suggest that electroporation is a safe procedure in the treatment of PDAC because it does not affect normal pancreatic parenchyma

A solid pseudopapillary neoplasm of the pancreas in a man presenting with acute pancreatitis: A case report

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Emi Chikuie

2017-01-01

Conclusion: We report a man with a small SPN of the pancreas presenting with acute pancreatitis and mimicking pancreatic cancer. We should be aware that this rare pancreatic tumor can become a cause of acute pancreatitis.

Duct-ectatic type of mucin producing tumor of the pancreas--new concept of pancreatic neoplasia.

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Kimura, W; Sasahira, N; Yoshikawa, T; Muto, T; Makuuchi, M

1996-01-01

Although there have been recent reports of mucin-producing tumor of the pancreas, there has been no thorough clinicopathological analysis of a large number of cases. Two hundred forty four cases of mucin-producing tumor of the pancreas from Japanese, European and American reports, together with 15 cases of our own, were analyzed clinicopathologically. Mucin-producing tumor of the pancreas was found in 177 males and 82 females (M:F = 2.2:1). The mean age was 65.5 years. Jaundice, diabetes mellitus and a past history of pancreatitis were found in 15%-19% of the cases. The tumor was most frequently (62%) found in the head of the pancreas. Pathologically, hyperplasia or adenoma was found in 58 cases, and adenocarcinoma in 160 cases. Five-year-survival rate by the Kaplan-Meier method was 82.6% in all of the cases and postoperative survival curve was much better in cases with this type of carcinoma than in cases with ordinary pancreatic duct cell carcinoma (5-year-survival rate: 82.6% vs 17.3%). Serum tumor markers such as CEA or CA 19-9 were not effective in differentiating between benign and malignant, or in determining the degree of cancerous spread, while cytology of the pancreatic juice and biopsy of the tumor could contribute to the diagnosis. Mucin-producing tumor has unique clinicopathological characteristics, such as the dilated main pancreatic duct or branches, dilatation of the orifice of the papilla of Vater, or good prognosis. Since a diagnosis for benign or malignant is very difficult in some cases, methods for distinguishing benign from malignant lesions or for determining cancerous spread, such as molecular biological techniques, should be established.

Enhancement of carcinogenesis and fatty infiltration in the pancreas in N-nitrosobis(2-oxopropyl)amine-treated hamsters by high-fat diet.

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Hori, Mika; Kitahashi, Tsukasa; Imai, Toshio; Ishigamori, Rikako; Takasu, Shinji; Mutoh, Michihiro; Sugimura, Takashi; Wakabayashi, Keiji; Takahashi, Mami

2011-11-01

Obesity is associated with increased pancreatic cancer risk, although the mechanisms have yet to be detailed. This study aimed to elucidate promotion of pancreatic cancer by obesity and hyperlipidemia. Six-week-old female Syrian golden hamsters were treated with N-nitrosobis(2-oxopropyl)amine (BOP) and after 1 week were fed a high-fat diet (HFD) or standard diet (STD) for 6 or 17 weeks. Body weight and serum levels of lipids and leptin were significantly higher in the HFD than the STD group at 14 weeks of age. Pancreatic ductal adenocarcinomas developed only in the BOP + HFD group, with an incidence of 67% (P pancreas. High-fat diet is shown to increase serum lipid levels and enhance fatty infiltration in the pancreas with abnormal adipocytokine production, which may accelerate and enhance pancreatic cancer.

Stabilization of beta-catenin induces pancreas tumor formation.

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Heiser, Patrick W; Cano, David A; Landsman, Limor; Kim, Grace E; Kench, James G; Klimstra, David S; Taketo, Maketo M; Biankin, Andrew V; Hebrok, Matthias

2008-10-01

beta-Catenin signaling within the canonical Wnt pathway is essential for pancreas development. However, the pathway is normally down-regulated in the adult organ. Increased cytoplasmic and nuclear localization of beta-catenin can be detected in nearly all human solid pseudopapillary neoplasms (SPN), a rare tumor with low malignant potential. Conversely, pancreatic ductal adenocarcinoma (PDA) accounts for the majority of pancreatic tumors and is among the leading causes of cancer death. Whereas activating mutations within beta-catenin and other members of the canonical Wnt pathway are rare, recent reports have implicated Wnt signaling in the development and progression of human PDA. Here, we sought to address the role of beta-catenin signaling in pancreas tumorigenesis. Using Cre/lox technology, we conditionally activated beta-catenin in a subset of murine pancreatic cells in vivo. Activation of beta-catenin results in the formation of large pancreatic tumors at a high frequency in adult mice. These tumors resemble human SPN based on morphologic and immunohistochemical comparisons. Interestingly, stabilization of beta-catenin blocks the formation of pancreatic intraepithelial neoplasia (PanIN) in the presence of an activating mutation in Kras that is known to predispose individuals to PDA. Instead, mice in which beta-catenin and Kras are concurrently activated develop distinct ductal neoplasms that do not resemble PanIN lesions. These results demonstrate that activation of beta-catenin is sufficient to induce pancreas tumorigenesis. Moreover, they indicate that the sequence in which oncogenic mutations are acquired has profound consequences on the phenotype of the resulting tumor.

Intraductal papillary-mucinous neoplasia of the pancreas: Histopathology and molecular biology

OpenAIRE

Verbeke, Caroline S

2010-01-01

Intraductal papillary-mucinous neoplasm (IPMN) of the pancreas is a clinically and morphologically distinctive precursor lesion of pancreatic cancer, characterized by gradual progression through a sequence of neoplastic changes. Based on the nature of the constituting neoplastic epithelium, degree of dysplasia and location within the pancreatic duct system, IPMNs are divided in several types which differ in their biological properties and clinical outcome. Molecular analysis and recent animal...

Adult Intussusception Caused by Heterotopic Pancreas

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Va-Kei Kok

2007-05-01

Full Text Available Heterotopic pancreas causing small bowel intussusception is rare. We report the case of a 24-year-old woman who presented with intermittent episodes of abdominal cramping and pain that had persisted for 10 days. A target-shaped lesion consisting of multiple concentric rings was found on the left side on contrast-enhanced computed tomography. Surgical intervention demonstrated jejunal intussusception caused by a jejunal heterotopic pancreas. Microscopically, several nesidioblastoses of pancreas were identified. Although very rare, small intestinal pancreatic rests may cause subacute bowel obstruction.

Solitary pancreas retransplant: Study of 22 cases

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Tércio Genzini

2006-03-01

Full Text Available Objective: To present our experience with pancreas retransplantin patients previously submitted to simultaneous pancreas-kidneytransplant, pancreas after kidney transplant and pancreastransplant alone. Methods: Between January/1996 and December/2005, 330 pancreas transplants were performed: 308 primarytransplants and 22 (6% retransplants of solitary pancreas. Thefollowing variables were analyzed: patient age; time elapsedbetween the first and the second transplant; causes of loss of thefirst graft; technical characteristics of the transplant andretransplant and the criteria for selecting donors for retransplant.These clinical data were submitted to statistical analysis. Results:The mean age of patients was 34.3 years and the mean elapsedtime between the first and second transplant was 19.3 months.The causes of the first graft loss were venous (8; 35% and arterial(5; 23% thrombosis, chronic rejection (4; 18%, ischemia/reperfusion injury (2, reflux pancreatitis (1, primary non-function(1 and sepsis (1. A second transplant was performed in thesame iliac fossa in 16 patients (72%. Venous drainage wasperformed in the iliac vein in 16 patients (72%, in the inferior venacava in 5 patients (22% and in the portal vein in one patient. 6 allbladder drainage was the technique used in 18 (82% cases andenteric drainage, in 4 patients (18%. Immunosuppressive regimenapplied to all cases was quadruple therapy with antilymphocyteinduction, tacrolimus, mycophenolate mofetil and steroids. Therewas one early death due to sepsis. One-year patient and pancreasgraft survival rates for retransplants were, respectively, 95% and85%. There was no additional risk for removing the pancreas graftat retransplant. Conclusion: Pancreas retransplant was technicallyfeasible in all cases and results similar to those described in theliterature were found for primary pancreas transplant.

Clinical imaging of the pancreas

International Nuclear Information System (INIS)

May, G.; Gardiner, R.

1987-01-01

Featuring more than 300 high-quality radiographs and scan images, clinical imaging of the pancreas systematically reviews all appropriate imaging modalities for diagnosing and evaluating a variety of commonly encountered pancreatic disorders. After presenting a succinct overview of pancreatic embryology, anatomy, and physiology, the authors establish the clinical indications-including postoperative patient evaluation-for radiologic examination of the pancreas. The diagnostic capabilities and limitations of currently available imaging techniques for the pancreas are thoroughly assessed, with carefully selected illustrations depicting the types of images and data obtained using these different techniques. The review of acute and chronic pancreatitis considers the clinical features and possible complications of their variant forms and offers guidance in selecting appropriate imaging studies

CT features of gastric heterotopic pancreas

International Nuclear Information System (INIS)

Wu Guangyao; Tian Zhixiong; Zhang Zaipeng; Huang Xiong

2007-01-01

Objective: To analyze CT findings correlated with pathologic findings in ectopic pancreas of the stomach. Methods: CT scans of 15 surgically proven eases of ectopic pancreas of the stomach were reviewed, and enhanced CT scan was performed in 11 cases. CT findings were correlated with the pathologic findings. Results: All cases had single lesion, and all lesions showed homogeneous density on plain scans without cystic or malignant changes. The size ranged from 1.3 to 3.1 cm, with mean diameter of (1.9±0.2) cm. The lesions were round or oval in shape with broad base against the gastric wall. Two showed central umbilication sign. Only 2 cases were correctly diagnosed prior to operation and the rest were misdiagnosed or diagnosed indistinctly. The locations were in the gastric antrum in 11 cases, in the body in 3, and in fundus in one; The ectopic pancreas located in the greater curvature in 10, and in the lesser curvature in 5. Homogeneous or inhomogeneous strong enhancement similar to the pancreas was seen in 8 cases and they consisted mainly of pancreatic acini with the same histologic features as the pancreas. Three cases showed poor enhancement and consisted mainly of ducts and hypertrophied muscle, pancreatic acini were a minor component. Conclusion: Ectopic pancreas of the stomach showed characteristic locations with the findings of submucosal diseases. Different enhancing patterns were correlated with their pathologic findings. (authors)

Dynamic Contrast Enhanced MRI in Patients With Advanced Breast or Pancreatic Cancer With Metastases to the Liver or Lung

Science.gov (United States)

2014-05-28

Acinar Cell Adenocarcinoma of the Pancreas; Duct Cell Adenocarcinoma of the Pancreas; Liver Metastases; Lung Metastases; Recurrent Breast Cancer; Recurrent Pancreatic Cancer; Stage IV Breast Cancer; Stage IV Pancreatic Cancer

Intraoperative radiotherapy for adenocarcinoma of the pancreas

International Nuclear Information System (INIS)

Yasue, Mitsunori; Yasui, Kenzo; Morimoto, Takeshi; Miyaishi, Seiichi; Morita, Kozo

1986-01-01

Thirty-six patients were given intraoperative radiotherapy for adenocarcinoma of the pancreas between April 1980 and March 1986. Twenty-six of those with well-advanced cancer underwent palliative intraoperative radiotherapy of their main primary lesions (1,500 to 3,000 rads). Fourteen of the 19 patients in this group who had intractable back pain before surgery achieved relief within one week after treatment. Of the remaining 10 patients who underwent pancreatectomy and received adjuvant intraoperative radiotherapy (2,000 to 3,000 rads), two remain clinically free of disease five years and six months and four years and six months after palliative distal pancreatectomy. (author)

Beta-Cell Replacement: Pancreas and Islet Cell Transplantation.

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Niclauss, Nadja; Meier, Raphael; Bédat, Benoît; Berishvili, Ekaterine; Berney, Thierry

2016-01-01

Pancreas and islet transplantation are 2 types of beta-cell replacement therapies for type 1 diabetes mellitus. Since 1966, when pancreas transplantation was first performed, it has evolved to become a highly efficient procedure with high success rates, thanks to advances in surgical technique and immunosuppression. Pancreas transplantation is mostly performed as simultaneous pancreas-kidney transplantation in patients with end-stage nephropathy secondary to diabetes. In spite of its efficiency, pancreas transplantation is still a major surgical procedure burdened by high morbidity, which called for the development of less invasive and hazardous ways of replacing beta-cell function in the past. Islet transplantation was developed in the 1970s as a minimally invasive procedure with initially poor outcomes. However, since the report of the 'Edmonton protocol' in 2000, the functional results of islet transplantation have substantially and constantly improved and are about to match those of whole pancreas transplantation. Islet transplantation is primarily performed alone in nonuremic patients with severe hypoglycemia. Both pancreas transplantation and islet transplantation are able to abolish hypoglycemia and to prevent or slow down the development of secondary complications of diabetes. Pancreas transplantation and islet transplantation should be seen as two complementary, rather than competing, therapeutic approaches for beta-cell replacement that are able to optimize organ donor use and patient care. © 2016 S. Karger AG, Basel.

SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION: EARLY POSTOPERATIVE COMPLICATIONS

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M.Sh. Khubutia

2014-01-01

Full Text Available Aim: evaluation of the incidence of early postoperative complications after simultaneous pancreas-kidney transplantation.Materials and methods. The analysis of early postoperative complications after simultaneous pancreas-kidney transplantation is presented in the paper, the most rational diagnostic algorithms, non-surgical and surgical complications’ treatment; the outcomes of the SPKT are reported.Results. 15,6% of patients experienced surgical complications, 12,5% – immunological complications, 12,5% – infectious complications, 6,25% – complications of the immunosuppressive therapy. 1-year patient survival after SPKT was 91,4%; pancreas graft survival – 85,7%; kidney graft survival – 88,6%.Conclusion. The incidence of early postoperative complications after simultaneous pancreas-kidney transplantation remains signifi cant in spite of progressive improvement of simultaneous pancreas-kidney transplantation due to surgical technique improvement, introduction of new antibacterial and immunosuppressive agents. Data, we recovered, fully correspond to the data obtained from the global medical community.

Annular pancreas in adult: a case report

International Nuclear Information System (INIS)

Moreira Neto, M.

1992-01-01

A case of a patient complaining of recurrent symptomatology of the upper abdomen and sub occlusion of the gastrointestinal tract with stenosis of the second portion of duodenum and mass evolving the head of pancreas at echographic study, confirmed by CT is presented. Contrasted oral studies confirmed that the mass evolved the stenotic segment, suggesting annular pancreas. Surgery confirmed the presence of annular pancreas surrounding the second portion of duodenum. (author)

The molecular and morphogenetic basis of pancreas organogenesis

DEFF Research Database (Denmark)

Larsen, Hjalte List; Grapin-Botton, Anne

2017-01-01

The pancreas is an essential endoderm-derived organ that ensures nutrient metabolism via its endocrine and exocrine functions. Here we review the essential processes governing the embryonic and early postnatal development of the pancreas discussing both the mechanisms and molecules controlling...... review of human pancreas development (Jennings et al., 2015) [1]. The understanding of pancreas development in model organisms provides a framework to interpret how human mutations lead to neonatal diabetes and may contribute to other forms of diabetes and to guide the production of desired pancreatic...

What an endoscopist should know about immunoglobulin-G4-associated disease of the pancreas and biliary tree

NARCIS (Netherlands)

Maillette de Buy Wenniger, L.; Rauws, E. A.; Beuers, U.

2012-01-01

Autoimmune pancreatitis (AIP) and IgG4-associated cholangitis (IAC) are the recently recognized pancreatobiliary manifestations of IgG4-associated systemic disease (ISD). Clinically, ISD of the pancreas and/or biliary tree may mimic pancreatic cancer, sclerosing cholangitis, or cholangiocarcinoma.

Diabetic Foot Complications Despite Successful Pancreas Transplantation.

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Seo, Dong-Kyo; Lee, Ho Seong; Park, Jungu; Ryu, Chang Hyun; Han, Duck Jong; Seo, Sang Gyo

2017-06-01

It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes. The mean age was 40.7 (range, 15-76) years. Diabetes type, transplantation type, body mass index, and diabetes duration before transplantation were confirmed. After pancreas transplantation, the occurrence and duration of foot and ankle complications were assessed. Twenty-two patients (10.1%) had diabetic foot complications. Fifteen patients (6.9%) had diabetic foot ulcer and 7 patients (3.2%) had Charcot arthropathy. Three patients had both diabetic foot ulcer and Charcot arthropathy. Three insufficiency fractures (1.4%) were included. Mean time of complications after transplantation was 18.5 (range, 2-77) months. Creatinine level 1 year after surgery was higher in the complication group rather than the noncomplication group ( P = .02). Complications of the foot and ankle still occurred following pancreas transplantation in patients with diabetes. Level III, comparative study.

A Study on Pancreas Scanning with Selenium{sup 75}-Selenomethionine

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Shin, Hyun Chan; Toh, Sang Hee; Ra, Woo Youn; Suh, Chul Sung [Presbyterian Hospital, Deagu (Korea, Republic of)

1968-03-15

Radiographic visualization of the pancreas is a difficult problem, but the direct visualization of the pancreas is possible by the injection of the amino-acid methionine tagged with selenium{sup 75} (Se{sup 75}). In order to know the diagnostic value of pancreas scanning, scans were performed on 23 cases using selenium{sup 75}-Selenomethionine. These cases were also given egg white, probanthine and morphine. 1) Good visualization of the pancreas scanning was observed on 19 cases, presumably with normal pancreas. 2) A case which showed diffusely decreased uptake on pancreas scanning was proven to have lesions in the bile duct and the gall bladder. 3) Of those two cases which showed localized cold area, one had pancreas cyst and the other one was not explored. 4) A case which showed no visualization of the pancreas was proven to have pancreatic carcinoma. 5) Two cases which showed widened duodenal loop by upper gastro-intestinal series revealed normal pancreas scanning, and no pancreatic disease was found in both cases.

Radiologic findings of annular pancreas divisum : a case report

International Nuclear Information System (INIS)

Choi, Dong Sik; Lee, Dong Ho; Ko, Young Tae; Han, Tae Il; Yoon, Youp; Dong, Suk Ho

1996-01-01

Annular pancreas divisum is a very rare congenital anomaly involving the coexistence of an annular pancreas and pancreatic divisum in one pancreas, and showing characteristic radiologic findings of ring-like pancreatic tissue surrounding the second portion of the duodenum and no evidence of connection between ventral and dorsal ductal systems. We described the radiologic findings of annular pancreas divisum, diagnosed by hypotonic duodenography, CT and ERCP

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

International Nuclear Information System (INIS)

Wan Haiyan; Korzh, Svitlana; Li Zhen; Mudumana, Sudha Puttur; Korzh, Vladimir; Jiang Yunjin; Lin Shuo; Gong Zhiyuan

2006-01-01

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

Current topics in glycemic control by wearable artificial pancreas or bedside artificial pancreas with closed-loop system.

Science.gov (United States)

Hanazaki, Kazuhiro; Munekage, Masaya; Kitagawa, Hiroyuki; Yatabe, Tomoaki; Munekage, Eri; Shiga, Mai; Maeda, Hiromichi; Namikawa, Tsutomu

2016-09-01

The incidence of diabetes is increasing at an unprecedented pace and has become a serious health concern worldwide during the last two decades. Despite this, adequate glycemic control using an artificial pancreas has not been established, although the 21st century has seen rapid developments in this area. Herein, we review current topics in glycemic control for both the wearable artificial pancreas for type 1 and type 2 diabetic patients and the bedside artificial pancreas for surgical diabetic patients. In type 1 diabetic patients, nocturnal hypoglycemia associated with insulin therapy remains a serious problem that could be addressed by the recent development of a wearable artificial pancreas. This smart phone-like device, comprising a real-time, continuous glucose monitoring system and insulin pump system, could potentially significantly reduce nocturnal hypoglycemia compared with conventional glycemic control. Of particular interest in this space are the recent inventions of a low-glucose suspend feature in the portable systems that automatically stops insulin delivery 2 h following a glucose sensor value <70 mg/dL and a bio-hormonal pump system consisting of insulin and glucagon pumps. Perioperative tight glycemic control using a bedside artificial pancreas with the closed-loop system has also proved safe and effective for not only avoiding hypoglycemia, but also for reducing blood glucose level variability resulting in good surgical outcomes. We hope that a more sophisticated artificial pancreas with closed-loop system will now be taken up for routine use worldwide, providing enormous relief for patients suffering from uncontrolled hyperglycemia, hypoglycemia, and/or variability in blood glucose concentrations.

Computed tomographic evaluation of the pancreas

International Nuclear Information System (INIS)

Stanley, R.J.; Sagel, S.S.

1979-01-01

Analysis of the clinical experience in the evaluation of the pancreas with computed tomography (CT) since October 1975 indicates that it is a reliable, often specific and relatively noninvasive method for the detection of pancreatic neoplasms and the varied manifestations of pancreatitis and its complications. The normal pancreas is clearly imaged in all but the leanest or uncooperative patients. Tumors of pancreas are identified as focal alteration in the size or contour of the gland. Obliteration of contiguous fat planes, areas of necrosis within the tumor, and secondary effects on the uninvolved parts of the pancreas and biliary tree can be identified. CBT has substantially reduced the need for pancreatic angiography, percutaneous transhepatic cholangiography, and endoscopic retrograde pancreatocholangiography at this medical center. Although a definitive comparison of ultrasound and CT has not yet been accomplished, initial experience indicates that a complementary rather than competitive relationship will develop between the two imaging methods. (orig.) 891 MG/orig. 892 MB [de

FoxO1 gain of function in the pancreas causes glucose intolerance, polycystic pancreas, and islet hypervascularization.

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Osamu Kikuchi

Full Text Available Genetic studies revealed that the ablation of insulin/IGF-1 signaling in the pancreas causes diabetes. FoxO1 is a downstream transcription factor of insulin/IGF-1 signaling. We previously reported that FoxO1 haploinsufficiency restored β cell mass and rescued diabetes in IRS2 knockout mice. However, it is still unclear whether FoxO1 dysregulation in the pancreas could be the cause of diabetes. To test this hypothesis, we generated transgenic mice overexpressing constitutively active FoxO1 specifically in the pancreas (TG. TG mice had impaired glucose tolerance and some of them indeed developed diabetes due to the reduction of β cell mass, which is associated with decreased Pdx1 and MafA in β cells. We also observed increased proliferation of pancreatic duct epithelial cells in TG mice and some mice developed a polycystic pancreas as they aged. Furthermore, TG mice exhibited islet hypervascularities due to increased VEGF-A expression in β cells. We found FoxO1 binds to the VEGF-A promoter and regulates VEGF-A transcription in β cells. We propose that dysregulation of FoxO1 activity in the pancreas could account for the development of diabetes and pancreatic cysts.

Progress and challenges of the bioartificial pancreas

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Hwang, Patrick T. J.; Shah, Dishant K.; Garcia, Jacob A.; Bae, Chae Yun; Lim, Dong-Jin; Huiszoon, Ryan C.; Alexander, Grant C.; Jun, Ho-Wook

2016-11-01

Pancreatic islet transplantation has been validated as a treatment for type 1 diabetes since it maintains consistent and sustained type 1 diabetes reversal. However, one of the major challenges in pancreatic islet transplantation is the body's natural immune response to the implanted islets. Immunosuppressive drug treatment is the most popular immunomodulatory approach for islet graft survival. However, administration of immunosuppressive drugs gives rise to negative side effects, and long-term effects are not clearly understood. A bioartificial pancreas is a therapeutic approach to enable pancreatic islet transplantation without or with minimal immune suppression. The bioartificial pancreas encapsulates the pancreatic islets in a semi-permeable environment which protects islets from the body's immune responses, while allowing the permeation of insulin, oxygen, nutrients, and waste. Many groups have developed various types of the bioartificial pancreas and tested their efficacy in animal models. However, the clinical application of the bioartificial pancreas still requires further investigation. In this review, we discuss several types of bioartificial pancreases and address their advantages and limitations. We also discuss recent advances in bioartificial pancreas applications with microfluidic or micropatterning technology.

Solid pseudopapillary tumors of the pancreas: 27 cases from a single institution

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ZHOU Haiyang

2013-01-01

Full Text Available ObjectiveTo summarize the clinicopathologic features and treatment outcomes of solid pseudopapillary tumors (SPTs of the pancreas. MethodsTwenty-seven cases of SPT of the pancreas admitted for treatment to the Peking University Cancer Hospital between September 2008 and September 2012 were retrospectively analyzed. ResultsThe majority of the pancreatic SPT patients were young adults (median age: 29 years old and females (85.2%. All 27 patients were treated with surgical resection using pancreaticoduodenectomy (n=4, duodenum preserving pancreatic tumor resection (n=6, middle pancreatectomy (n=5, distal pancreatectomy (n=5, or distal pancreatectomy plus splenectomy (n=7. The minimum tumor diameter was 1.5 cm, the maximum diameter was 12.0 cm, and the average diameter was 5.4 cm. Twelve patients developed pancreatic leakage and pyrexia following the operation. One patient suffered splenic artery hemorrhage. All 27 patients survived and completed follow-up. Only one patient developed recurrence, which was treated by a second surgical resection, and all other patients showed no clinical signs of recurrence or metastasis. ConclusionSPT of the pancreas has uncertain malignant potential with good prognosis. Radical resection with preservation of the surrounding tissues is an effective and safe treatment for SPT.

Accompanying role of hepato-biliary-pancreas surgeon in urological surgery

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Atsushi Nanashima

Full Text Available Introduction: The present case reports demonstrated the accompanying surgical support from hepato-biliary-pancreas (HBP surgeons for urological surgery to secure operative safety because HBP surgeons are well experienced in dissecting techniques for mobilization of the liver or pancreas. We experienced 9 consecutive patients who underwent nephrectomy, adrenectomy or resection of retroperitoneal tumors by urological surgeons. Cardiovascular intervention was also required in cases of long tumor thrombus into the vena cava. Cases: All patients had no severe co-existing diseases except the main tumor. Reverse T-shape incision was performed in 7 cases and thoracolaparotomy in two. Dissection and mobilization at the site of severe compression by the urinary tumors were performed in three cases. Partial liver resection was performed for testicular liver metastases in two, and right hepatectomy for right renal cancer was performed in one. Encircling the vena cava and preparation of transection for tumor thrombi were performed in three, and among these, cardiovascular intervention was necessary in two because of extension into the right atrium. During admission, all patient outcomes were uneventful without severe complications. We herein showed the representative two cases of combined surgery. Discussion: and conclusion The point of this case report is the coordination between each surgeon and anesthesiologist under precise perioperative planning or management. The role of HBP surgeons is to provide information as a specialist on the operative field for urological or cardiovascular surgery to achieve operative safety. Keywords: Hepato-biliary-pancreas surgeon, Joint surgery, Urology

Economic burden of cancer across the European Union: a population-based cost analysis.

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Luengo-Fernandez, Ramon; Leal, Jose; Gray, Alastair; Sullivan, Richard

2013-11-01

In 2008, 2·45 million people were diagnosed with cancer and 1·23 million died because of cancer in the 27 countries of the European Union (EU). We aimed to estimate the economic burden of cancer in the EU. In a population-based cost analysis, we evaluated the cost of all cancers and also those associated with breast, colorectal, lung, and prostate cancers. We obtained country-specific aggregate data for morbidity, mortality, and health-care resource use from international and national sources. We estimated health-care costs from expenditure on care in the primary, outpatient, emergency, and inpatient settings, and also drugs. Additionally, we estimated the costs of unpaid care provided by relatives or friends of patients (ie, informal care), lost earnings after premature death, and costs associated with individuals who temporarily or permanently left employment because of illness. Cancer cost the EU €126 billion in 2009, with health care accounting for €51·0 billion (40%). Across the EU, the health-care costs of cancer were equivalent to €102 per citizen, but varied substantially from €16 per person in Bulgaria to €184 per person in Luxembourg. Productivity losses because of early death cost €42·6 billion and lost working days €9·43 billion. Informal care cost €23·2 billion. Lung cancer had the highest economic cost (€18·8 billion, 15% of overall cancer costs), followed by breast cancer (€15·0 billion, 12%), colorectal cancer (€13·1 billion, 10%), and prostate cancer (€8·43 billion, 7%). Our results show wide differences between countries, the reasons for which need further investigation. These data contribute to public health and policy intelligence, which is required to deliver affordable cancer care systems and inform effective public research funds allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Improving Goals of Care Discussion in Advanced Cancer Patients

Science.gov (United States)

2017-08-23

Primary Stage IV Hepatobiliary; Esophageal; Colorectal Cancer; Glioblastoma; Cancer of Stomach; Cancer of Pancreas; Melanoma; Head or Neck Cancer; Stage III; Stage IV; Lung Cancers; Pancreatic Cancers

Pancreas transplantation: an overview

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Andre Ibrahim David

2010-12-01

Full Text Available Pancreas transplantation is the only treatment able to reestablish normal glucose and glycated hemoglobin levels in insulin-dependent diabetic patients without the use of exogenous insulin. The evolution of pancreas transplantation in treatment of diabetes was determined by advances in the fields of surgical technique, organ preservation and immunosuppressants. The main complication leading to graft loss is technical failure followed by acute or chronic rejection. Technical failure means graft loss within the first three months following transplantation due to vascular thrombosis (50%, pancreatitis (20%, infection (18%, fistula (6.5% and bleeding (2.4%. Immunological complications still affect 30% of patients, and rejection is the cause of graft loss in 10% of cases. Chronic rejection is the most common late complication. Cardiovascular diseases are the most common causes of late mortality in pancreas transplantation, so it remains the most effective treatment for type 1 diabetes patients. There is a significant improvement in quality of life and in patient’s survival rates. The development of islet transplantation could eliminate or minimize surgical complications and immunosuppression.

Metastatic Renal Cell Carcinoma to the Pancreas: A Review.

Science.gov (United States)

Cheng, Shaun Kian Hong; Chuah, Khoon Leong

2016-06-01

The pancreas is an unusual site for tumor metastasis, accounting for only 2% to 5% of all malignancies affecting the pancreas. The more common metastases affecting the pancreas include renal cell carcinomas, melanomas, colorectal carcinomas, breast carcinomas, and sarcomas. Although pancreatic involvement by nonrenal malignancies indicates widespread systemic disease, metastatic renal cell carcinoma to the pancreas often represents an isolated event and is thus amenable to surgical resection, which is associated with long-term survival. As such, it is important to accurately diagnose pancreatic involvement by metastatic renal cell carcinoma on histology, especially given that renal cell carcinoma metastasis may manifest more than a decade after its initial presentation and diagnosis. In this review, we discuss the clinicopathologic findings of isolated renal cell carcinoma metastases of the pancreas, with special emphasis on separating metastatic renal cell carcinoma and its various differential diagnoses in the pancreas.

Union banking a step towards achieving fiscal Union in the European Union

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Ionuţ Marius Croitoru

2015-05-01

Full Text Available Introduction: Union policy needs in addition to the official language of four major components: a monetary union, a fiscal union, a union diplomatic and military union A stage in the Union is the Union banking tax. Materials and Methods: Union Bank has three pillars: a single banking supervisor (single supervisory mechanism, the only mechanism of bank resolution and a single scheme of bank guarantees. Results and conclusions: Union Bank, strengthen supervision is an inevitable process, and Romania will have to enroll in it. Option Romania is to be part of Romania deaorece bank Union can not remain outside the structures of decision as long as banks operating in Romania are predominantly Eurozone.

File list: Unc.Pan.10.AllAg.Pancreas [Chip-atlas[Archive

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Lifescience Database Archive (English)

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Endosonographic Features of Histologically Proven Gastric Ectopic Pancreas

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Jen-Wei Chou

2014-01-01

Full Text Available 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.

Plasma protein profiling of patients with intraductal papillary mucinous neoplasm of the pancreas as potential precursor lesions of pancreatic cancer.

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Ilies, Maria; Sappa, Praveen Kumar; Iuga, Cristina Adela; Loghin, Felicia; Gesell Salazar, Manuela; Weiss, Frank Ulrich; Beyer, Georg; Lerch, Markus M; Völker, Uwe; Mayerle, Julia; Hammer, Elke

2018-02-01

Efforts for the early diagnosis of the pancreatic ductal adenocarcinoma (PDAC) have recently been driven to one of the precursor lesions, namely intraductal papillary mucinous neoplasm of the pancreas (IPMN). Only a few studies have focused on IPMN molecular biology and its overall progression to cancer. Therefore, IPMN lacks comprehensive characterization which makes its clinical management controversial. In this study, we characterized plasma proteins in the presence of IPMNs in comparison to healthy controls, chronic pancreatitis, and PDAC by a proteomics approach using data-independent acquisition based mass spectrometry. We describe several protein sets that could aid IPMN diagnosis, but also differentiation of IPMN from healthy controls, as well as from benign and malignant diseases. Among all, high levels of carbonic anhydrases and hemoglobins were characteristic for the IPMN group. By employing ELISA based quantification we validated our results for human tissue inhibitor of metalloproteinase inhibitor 1 (TIMP-1). We consider IPMN management directed towards an early potential cancer development a crucial opportunity before PDAC initiation and thus its early detection and cure. Copyright © 2017 Elsevier B.V. All rights reserved.

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Pancreas Volume and Fat Deposition in Diabetes and Normal Physiology: Consideration of the Interplay Between Endocrine and Exocrine Pancreas

OpenAIRE

Saisho, Yoshifumi

2016-01-01

The pancreas is comprised of exocrine and endocrine components. Despite the fact that they are derived from a common origin in utero, these two compartments are often studied individually because of the different roles and functions of the exocrine and endocrine pancreas. Recent studies have shown that not only type 1 diabetes (T1D), but also type 2 diabetes (T2D), is characterized by a deficit in beta-cell mass, suggesting that pathological changes in the pancreas are critical events in the ...

The Miracle of an Artificial Pancreas | NIH MedlinePlus the Magazine

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... Diabetes Follow us The Miracle of an Artificial Pancreas Four NIH-funded Artificial Pancreas Research Efforts Underway Thanks to investments in new ... diabetes are on the horizon, including the artificial pancreas. The artificial pancreas is an integrated system that ...

Endoscopic findings following retroperitoneal pancreas transplantation.

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Pinchuk, Alexey V; Dmitriev, Ilya V; Shmarina, Nonna V; Teterin, Yury S; Balkarov, Aslan G; Storozhev, Roman V; Anisimov, Yuri A; Gasanov, Ali M

2017-07-01

An evaluation of the efficacy of endoscopic methods for the diagnosis and correction of surgical and immunological complications after retroperitoneal pancreas transplantation. From October 2011 to March 2015, 27 patients underwent simultaneous retroperitoneal pancreas-kidney transplantation (SPKT). Diagnostic oesophagogastroduodenoscopy (EGD) with protocol biopsy of the donor and recipient duodenal mucosa and endoscopic retrograde pancreatography (ERP) were performed to detect possible complications. Endoscopic stenting of the main pancreatic duct with plastic stents and three-stage endoscopic hemostasis were conducted to correct the identified complications. Endoscopic methods showed high efficiency in the timely diagnosis and adequate correction of complications after retroperitoneal pancreas transplantation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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Complete agenesis of the dorsal pancreas: Case report with ...

African Journals Online (AJOL)

pancreatic head and uncinate process were normal, but the distal neck, body ... The neck, body, tail, and cephalic aspects of the head of the pancreas originate from the .... Embryology, normal variation, and congenital anomalies of the pancreas. ... M. A 3D reconstruction of pancreas development in the human embryos.

Sonographic evaluation of retroperitoneal pancreas transplants and their complications

International Nuclear Information System (INIS)

Rao, B.K.; Rosnberg, R.; McDermott, J.C.; Sollinger, H.W.; Belzer, F.O.

1986-01-01

Pancreas transplantation is an experimental procedure performed to restore insulin secretion in patients with diabetes mellitus. The authors reviewed 65 real-time sonograms in 42 kidney transplant recipients who also had a homologous pancreas transplanted into the retroperitoneum. Sonograms were analyzed for size of the pancreas transplant, its echo texture, size of the pancreatic duct, fluid collections around the pancreas transplant, vascular pulsations, and anastomotic site between the pancreatic duct and the urinary bladder. A normal pancreas transplant is moderately echogenic and may have small hypoechoic areas (possibly representing fibrosis or infarcts) in the early postsurgical period (based on findings in 14 of 42 patients). Dilation of the pancreatic duct (3-9 mm) and air in the pancreatic duct were common postoperatively. Pancreatitis was also common (36 patients) and was recognized by an increase in the size of the pancreas transplant and by a focally or diffusely hypoechoic texture. Rejection of the pancreas transplant was uncommon (six patients) and was detected on the basis of reduced vascular flow, an increase in size of the pancreas transplant, and a nonhomogeneous echotexture. Infraction of the transplant was rare and had an irregular, nonhomogeneously hypoechoic appearance (two patients). Seromas (eight patients), abscesses (three), and hematomas (two) were detected on the basis of septa, floating debris, mural nodules, and irregular thick walls. Enzymatic fat necrosis was recognized from floating echogenic fat debris (two patients). Air-containing abscesses were identified and confirmed on CT or US-guided aspiration (three patients). US was extremely useful for detecting, localizing, and characterizing fluid collections and provided guidance for aspiration. It is the imaging modality of choice for screening pancreas transplant recipients for postoperative changes

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Design of a bioartificial pancreas

Science.gov (United States)

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

2013-01-01

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

MR imaging of the normal pancreas

International Nuclear Information System (INIS)

Itoh, Hisao; Takahashi, Norio; Uchida, Yoshie; Nakayama, Gen; Bito, Kaoru; Haba, Hirotsugu; Kawamura, Masashi; Kataoka, Masaaki; Hamamoto, Ken.

1989-01-01

To evaluate current 1.5-T MR imaging with respiratory ordered phase encoding (ROPE) technique in the identification of pancreatic contour and main pancreatic duct, 100 normal subjects examined with spin echo technique including transaxial scans of T 1 -WI,T 2 -WI, and proton density (PD)-WI were reviewed. The results of MR imaging were then compared with computed tomography (CT). Pancreatic contour was divided into 3 parts; head, body, and tail. T 1 -WI was the best pulse sequence in describing pancreas and the rates of specific identification of head, body, and tail were 69%, 97%, and 92%, respectively. While these rates were 62%, 90%, and 92% with plain CT and 69%, 94%, and 94% with contrast-enhanced CT, respectively. A combination of MR imaging and CT yielded better rates of identification. The main pancreatic duct was visible in 44% as a low intensity line on T 1 -WI and in 16% on plain CT. Dorsal to pancreas, all of the major vessels were seen in every patients. Ventrally, retroperitoneal fat was important, however, it was not a limiting factor. When respiratory compensation using ROPE functioned well, it was possible to differentiate bowel from pancreas in patients with sparse fat because signal intensity of the pancreas tended to be higher than that of gastrointestinal wall and its contents on T 1 -WI. Current MR imaging seemed to be a complementary method with CT in the identification of the pancreas. (author)

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Lifescience Database Archive (English)

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Lifescience Database Archive (English)

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Cancer pancreatis, diagnostic procedures

International Nuclear Information System (INIS)

Graadal, Oe.; Schlichting, E.; Aasen, A.O.; Stadaas, J.O.

1990-01-01

151 patients treated for carcinoma of the pancreas at Ullevaal Hospital (Oslo University) during the period 1980-89 were studied. The most common initial symptom was abdominal pain. Other frequent debut symptoms were loss of weight and jaundice. ERCP and PTC were found to be the best diagnostic procedures. CT or ultrasonography were normal in 10-20% of the patients. Nearly all tumors of the pancreas were found by the ERCP procedure. Also angiography was used to evaluate operability of the pancreas tumor, but was found to be a very uncertain diagnostic method. This method will not be used in the future evaluation of patients with cancer of the pancreas. 13 refs., 1 fig., 2 tabs

Unemployment, public-sector health-care spending and breast cancer mortality in the European Union: 1990-2009.

Science.gov (United States)

Maruthappu, Mahiben; Watkins, Johnathan A; Waqar, Mueez; Williams, Callum; Ali, Raghib; Atun, Rifat; Faiz, Omar; Zeltner, Thomas

2015-04-01

The global economic crisis has been associated with increased unemployment, reduced health-care spending and adverse health outcomes. Insights into the impact of economic variations on cancer mortality, however, remain limited. We used multivariate regression analysis to assess how changes in unemployment and public-sector expenditure on health care (PSEH) varied with female breast cancer mortality in the 27 European Union member states from 1990 to 2009. We then determined how the association with unemployment was modified by PSEH. Country-specific differences in infrastructure and demographic structure were controlled for, and 1-, 3-, 5- and 10-year lag analyses were conducted. Several robustness checks were also implemented. Unemployment was associated with an increase in breast cancer mortality [P unemployment rises (P unemployment and breast cancer mortality remained in all robustness checks. Rises in unemployment are associated with significant short- and long-term increases in breast cancer mortality, while increases in PSEH are associated with reductions in breast cancer mortality. Initiatives that bolster employment and maintain total health-care expenditure may help minimize increases in breast cancer mortality during economic crises. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Solitary Fibrous Tumor of the Pancreas: Imaging Findings

International Nuclear Information System (INIS)

Kwon, Heon Ju; Byun, Jae Ho; Kang, Jun; Park, Seong Ho; Lee, Moon Gyu

2008-01-01

We report here a case of a pathologically proven solitary fibrous tumor of the pancreas. A 54-year-old man was referred to our hospital for further evaluation of a pancreatic mass that was found incidentally. CT, MR imaging, and endoscopic ultrasonography showed a well-defined, enhancing mass with cystic portions of the pancreas body. MR cholangiopancreatography showed no pancreatic duct dilatation. A solitary fibrous tumor of the pancreas is a very rare lesion

Primary hydatid cysts of the pancreas

African Journals Online (AJOL)

Kurt

Hydatid cysts of the pancreas are rare. The reported incidence varies from 0.1% to 2% of patients with hydatid disease.4-7. Management may be diffi- cult as a hydatid cyst in the head of the pancreas may closely simulate a cystic tumour. In this study we report 4 cases of primary hydatid cysts involving the head of the ...

Intrapancreatic Splenule in a Pancreas Allograft: Case Report.

Science.gov (United States)

Yadav, K; Serrano, O K; Kandaswamy, R

2016-11-01

A 16-year-old white man was involved in a motor vehicle collision and suffered head, chest, and abdominal trauma. Despite initial resuscitative efforts, he progressed to brain death and was designated to be an organ donor by his family. He had no earlier medical or surgical history and no high-risk behaviors. Blood work revealed normal creatinine, liver function tests, lipase, and amylase. Viral serologies were negative except for cytomegalovirus IgG and Epstein-Barr virus nucleic acid. Imaging revealed a right kidney contusion, a manubrial fracture, and fractures of right first rib and bilateral scapulae. No other abdominal trauma was identified, specifically to the pancreas, duodenum, or spleen. Our transplant center accepted the pancreas from this donor. During back-table inspection of the pancreas, a 1.5 × 1.5 cm dark purple rubbery mass was identified within the parenchyma of the pancreas in the tail. An incisional biopsy of the lesion was sent for frozen section, which yielded a mixed inflammatory infiltrate consisting of neutrophils and lymphocytes and an overlying fibrous capsule. The diagnosis of lymphoma or another neoplasm could not be definitely ruled out. Owing to uncertainty in diagnosis, the entire lesion was excised along with the distal pancreas with the use of a linear stapler. The staple line was oversewn with running 4-0 polypropylene suture, and the pancreas was transplanted. After surgery, the pancreas allograft functioned well with a small pancreatic leak, which had resolved by the first postoperative outpatient visit. Published by Elsevier Inc.

Dual-phase CT of the liver and the pancreas

International Nuclear Information System (INIS)

Dragiyski, B.; Velkova, K.

2004-01-01

This survey covers the introduction of Spiral CT in the diagnostics of lesions of the liver and the pancreas. It describes the possibility to display separate images of the arterial and portal-venous phases of saturation of the liver and the pancreas. It also considers the indications leading to use of dual-phase Spiral CT on the liver and the pancreas. We trace the development of the dual-phase Spiral CT in visualization of the structure of blood vessels in the area of liver and pancreas. The survey puts forward the potential of the dual-phase method to improve the diagnostics and description of many primary and secondary malignant tumors of the liver and the pancreas, their differentiation from benign neoplasm, as well as the existing problems and some controversial aspects of its application

In vitro pancreas organogenesis from dispersed mouse embryonic progenitors

DEFF Research Database (Denmark)

Greggio, Chiara; De Franceschi, Filippo; Figueiredo-Larsen, Evan Manuel

2014-01-01

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...... 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...

Ectopic pancreas with pseudocyst and pseudoaneurysm formation

International Nuclear Information System (INIS)

Surov, A.; Hainz, M.; Hinz, L.; Holzhausen, H.-J.; Finke, R.; Spielmann, R.-P.; Kunze, C.

2009-01-01

Ectopic pancreas is a rare congenital anomaly. It is usually asymptomatic, or presents with non specific gastrointestinal symptoms. We describe here a case of ectopic pancreas in the gastric antrum, with pseudocyst and pseudoaneurysm formation. This entity has not been reported previously in the literature.

Resection of oligometastatic lung cancer to the pancreas may yield a survival benefit in select patients--a systematic review.

Science.gov (United States)

DeLuzio, Matthew R; Moores, Craig; Dhamija, Ankit; Wang, Zuoheng; Cha, Charles; Boffa, Daniel J; Detterbeck, Frank C; Kim, Anthony W

2015-01-01

To conduct a systematic review of the existing literature regarding surgical therapy for oligometastatic lung cancer to the pancreas. Data was collected on patients with singular pancreatic metastases from lung cancer from papers published between January 1970 and June 2014. This was performed following the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines. Kaplan-Meier and Cox Regression analyses were then used to determine and compare survival. There were 27 papers that fulfilled the search criteria, from which data on 32 patients was collected. Non-small cell lung cancer (NSCLC) was the most prevalent type of primary lung malignancy, and metachronous presentations of metastases were most common. Lesions were most frequently located in the pancreatic head and consequently the most common curative intent metastasectomy was pancreaticoduodenectomy. There was a statistically significant survival benefit for patients whose metastasis were discovered incidentally by surveillance CT as opposed to those whose metastasis were discovered during a work up for new somatic complaints (p = 0.024). The overall median survival for patients undergoing curative intent resection was 29 months, with 2-year and 5-year survivals of 65% and 21% respectively. Palliative surgery or medical only management was associated with a median survival of 8 months and 2-year and 5-year survivals of 25% and 8% respectively. Curative intent resection of isolated pancreatic metastasis from lung cancer may be beneficial in a select group of patients. Copyright © 2015 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Autoradiography of manganese: accumulation and retention in the pancreas

International Nuclear Information System (INIS)

Lyden, A.; Lindquist, N.G.; Larsson, B.S.

1983-01-01

By means of whole-body autoradiography, the general distribution of 54 MnCl 2 was studied in mice and a Marmoset monkey. High accumulation and retention were observed in the pancreas in both species. Gamma counting experiments in mice after a single intravenous injection of 54 MnCl 2 showed that the level in the pancreas exceeded that of the liver at all survival times (20 min. - 30 days). Also in the monkey, the concentration in the pancreas exceeded that of the liver, and the pancreas had the highest tissue/liver ratio of the organs measured at 24 hours after injection. The high uptake and long retention in the pancreas suggest that manganese is of importance for the pancreatic function but also that the pancreas may be a target organ for manganese toxicity. Positron tomography, using 11 C-labelled amino acids, has been found to be a promising diagnostic technique for the study of pancreatic disease. Positron emitting manganese isotopes may be worth further studies as possible agents for pancreatic imaging. (author)

Expanding the indications of pancreas transplantation alone.

Science.gov (United States)

Mehrabi, Arianeb; Golriz, Mohammad; Adili-Aghdam, Fatemeh; Hafezi, Mohammadreza; Ashrafi, Maryam; Morath, Christian; Zeier, Martin; Hackert, Thilo; Schemmer, Peter

2014-11-01

Total pancreatectomy (TP) is associated with postoperative endocrine and exocrine insufficiency. Especially, insulin therapy reduces quality of life and may lead to long-term complications. We review the literature with regard to the potential option of pancreas transplantation alone (PTA) after TP in patients with chronic pancreatitis or benign tumors. A MEDLINE search (1958-2013) using the terminologies pancreas transplantation, pancreas transplantation alone, total pancreatectomy, morbidity, mortality, insulin therapy, and quality of life was performed. In addition, the current book and congress publications were reviewed. Total pancreatectomy after benign and borderline tumors as well as chronic pancreatitis is continuously increasing. Despite improvement of exogenous insulin therapy, more than 50% of these patients experience severe glucose control problems, which cause up to 50% long-term mortality. Pancreas transplantation alone can cure both endocrine and exocrine insufficiency and reduce the associated risks. The 3-year graft and patient survival rates after PTA are up to 73% and 100%, respectively. Pancreas transplantation alone after TP in patients with pancreatitis or benign tumors improves the recipient's quality of life and reduces long-term mortality. Considering the amount of available organs and potential candidates, PTA can be a treatment option for patients after TP with chronic pancreatitis or benign tumors.

Agenesis of the dorsal pancreas

Science.gov (United States)

Schnedl, Wolfgang J; Piswanger-Soelkner, Claudia; Wallner, Sandra J; Krause, Robert; Lipp, Rainer W

2009-01-01

During the last 100 years in medical literature, there are only 54 reports, including the report of Pasaoglu et al (World J Gastroenterol 2008; 14: 2915-2916), with clinical descriptions of agenesis of the dorsal pancreas in humans. Agenesis of the dorsal pancreas, a rare congenital pancreatic malformation, is associated with some other medical conditions such as hyperglycemia, abdominal pain, pancreatitis and a few other diseases. In approximately 50% of reported patients with this congenital malformation, hyperglycemia was demonstrated. Evaluation of hyperglycemia and diabetes mellitus in all patients with agenesis of the dorsal pancreas including description of fasting blood glucose, oral glucose tolerance test, glycated hemoglobin and medical treatment would be a future goal. Since autosomal dominant transmission has been suggested in single families, more family studies including imaging technologies with demonstration of the pancreatic duct system are needed for evaluation of this disease. With this letter to the editor, we aim to increase available information for the better understanding of this rare disease. PMID:19140241

Microcystic adenoma of the pancreas

Directory of Open Access Journals (Sweden)

Čolović Radoje B.

2002-01-01

Full Text Available Microcystic adenoma of the pancreas is a rare benign tumour of the pancreas without malignant potential which usually appears in older women. Pain weight loss, palpable mass and jaundice (if the tumor is localized in the head of the pancreas are the main symptoms. Thanks to the modern imaging techniques (US, CT, FNB the tumor is discovered and with rising frequency exactly preoperatively diagnosed. Surgical excision is the treatment of choice. In risk patients without symptoms surgery is not necessary but patients have to be regularly followed-up. The authors present a 70-year old woman in whom, because of constant epigastric pain, a multicystic mass of the pancreatic body, 58 x 40 mm in diameter, was discovered and removed by distal pancreatectomy. The spleen could not be saved. Histologic examination showed a microcystic adenoma. Three years after surgery the patient is symptom-free with normal ultra-sonographic findings.

Vasoactive intestinal polypeptide (VIP) in the pig pancreas

DEFF Research Database (Denmark)

Poulsen, Steen Seier

1984-01-01

Vasoactive intestinal polypeptide (VIP) in the pig pancreas is localized to nerves, many of which travel along the pancreatic ducts. VIP stimulates pancreatic fluid and bicarbonate secretion like secretin. Electrical vagal stimulation in the pig causes an atropine-resistant profuse secretion...... of bicarbonate-rich pancreatic juice. In an isolated perfused preparation of the pig pancreas with intact vagal nerve supply, electrical vagal stimulation caused an atropine-resistant release of VIP, which accurately parallelled the exocrine secretion of juice and bicarbonate. Perfusion of the pancreas...... with a potent VIP-antiserum inhibited the effect of vagal stimulation on the exocrine secretion. It is concluded, that VIP is responsible for (at least part of) the neurally controlled fluid and bicarbonate secretion from the pig pancreas....

Vascular development in the vertebrate pancreas

Science.gov (United States)

Azizoglu, D. Berfin; Chong, Diana C.; Villasenor, Alethia; Magenheim, Judith; Barry, David M.; Lee, Simon; Marty-Santos, Leilani; Fu, Stephen; Dor, Yuval; Cleaver, Ondine

2016-01-01

The vertebrate pancreas is comprised of a highly branched tubular epithelium, which is intimately associated with an extensive and specialized vasculature. While we know a great deal about basic vascular anatomy of the adult pancreas, as well as islet capillaries, surprisingly little is known about the ontogeny of its blood vessels. Here, we analyze development of the pancreatic vasculature in the mouse embryo. We show that pancreatic epithelial branches intercalate with the fine capillary plexus of the surrounding pancreatic mesenchyme. Endothelial cells (ECs) within this mesenchyme are heterogeneous from the onset of organogenesis. Pancreatic arteries take shape before veins, in a manner analogous to early embryonic vessels. The main central artery forms during mid-gestation, as a result of vessel coalescence and remodeling of a vascular plexus. In addition, we show that vessels in the forming pancreas display a predictable architecture that is dependent on VEGF signaling. Over-expression of VEGF disrupts vascular patterning and arteriovenous differentiation within the developing pancreas. This study constitutes a first-time cellular and molecular characterization of pancreatic blood vessels, as they coordinately grow along with the pancreatic epithelium. PMID:27789228

Vascular development in the vertebrate pancreas.

Science.gov (United States)

Azizoglu, D Berfin; Chong, Diana C; Villasenor, Alethia; Magenheim, Judith; Barry, David M; Lee, Simon; Marty-Santos, Leilani; Fu, Stephen; Dor, Yuval; Cleaver, Ondine

2016-12-01

The vertebrate pancreas is comprised of a highly branched tubular epithelium, which is intimately associated with an extensive and specialized vasculature. While we know a great deal about basic vascular anatomy of the adult pancreas, as well as islet capillaries, surprisingly little is known about the ontogeny of its blood vessels. Here, we analyze development of the pancreatic vasculature in the mouse embryo. We show that pancreatic epithelial branches intercalate with the fine capillary plexus of the surrounding pancreatic mesenchyme. Endothelial cells (ECs) within this mesenchyme are heterogeneous from the onset of organogenesis. Pancreatic arteries take shape before veins, in a manner analogous to early embryonic vessels. The main central artery forms during mid-gestation, as a result of vessel coalescence and remodeling of a vascular plexus. In addition, we show that vessels in the forming pancreas display a predictable architecture that is dependent on VEGF signaling. Over-expression of VEGF disrupts vascular patterning and arteriovenous differentiation within the developing pancreas. This study constitutes a first-time in-depth cellular and molecular characterization of pancreatic blood vessels, as they coordinately grow along with the pancreatic epithelium. Copyright © 2016 Elsevier Inc. All rights reserved.

Primary Extraskeletal Mesenchymal Chondrosarcoma Arising from the Pancreas

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Oh, Bae Geun; Han, Yoon Hee; Lee, Byung Hoon; Kim, Su Young; Hwang, Yoon Joon; Seo, Jung Wook; Kim, Yong Hoon; Cha, Soon Joo; Hur, Gham; Joo, Mee [Inje University, School of Medicine, Goyang (Korea, Republic of)

2007-12-15

The CT scans showed a heterogeneously enhancing necrotic mass with numerous areas of coarse calcification, and this was located in the left side of the retroperitoneal space and involved the body and tail of the pancreas. Portal venography via the celiac axis also showed invasion of the splenic vein. It represents approximately 1% of all chondrosarcomas and it carries a poor prognosis. It can occur in extraskeletal locations and mainly in the soft tissues of the orbit, the cranial and spinal meningeal coverings and the lower limbs. To the best of our knowledge, there has been no reported case of primary extraskeletal mesenchymal chondrosarcoma of the pancreas. Only two instances of metastatic chondrosarcomas in the pancreas have been reported in the literature. We report here on a case of primary mesenchymal chondrosarcoma arising from the pancreas in a 41-year-old man. In summary, we present here a case of primary extraskeletal mesenchymal chondrosarcoma that arose from the pancreas. Radiologically, it manifested as a necrotic soft tissue mass with chondroid calcifications.

Cancer in the Norwegian printing industry.

Science.gov (United States)

Kvam, Bård M N; Romundstad, Pål Rikard; Boffetta, Paolo; Andersen, Aage

2005-02-01

The aim of this study was to investigate cancer risk among Norwegian workers in the printing industry, particularly lung and bladder cancer. Cancer incidence was investigated from 1953 through 1998 in a cohort of 10 549 male members of a trade union in the printing industry in Oslo and nearby areas. Rates from the region, were used to calculate standardized incidence ratios (SIR) separately for the skilled and unskilled workers. Smoking data from a sample of the cohort were utilized for evaluating the risk estimates of smoking-related cancers. Specific exposure data were not available. Among the skilled workers, significantly elevated risks of cancer of the urinary bladder [standardized incidence ratio (SIR) 1.47, 95% confidence interval (95% CI) 1.19-1.79], liver (SIR 1.92, 95% CI 1.15-2.99), pancreas (SIR 1.46, 95% CI 1.07-1.94) and colon (SIR 1.27, 95% CI 1.05-1.55) were observed, whereas an increased risk of lung cancer in this group was confined to those born before 1910. Among the unskilled workers, there were significantly increased risks of cancer of the mouth, esophagus, stomach, larynx, lung, and all sites. The study showed that workers in the printing industry were at increased risk of several types of cancer. In particular the increased risk of bladder cancer among the skilled workers is suggestive of an occupational cause. However, no specific agent could be identified as an occupational carcinogen. The results did not support the hypothesis of a generally increased risk of lung cancer. The risk pattern for unskilled workers may reflect confounding by nonoccupational factors.

Disseminated carcinomatosis of the bone marrow from pancreatic cancer: a case report

International Nuclear Information System (INIS)

Namikawa, Hiroki; Takemoto, Yasuhiko; Makuuchi, Ayako; Kobayashi, Masanori; Kinuhata, Shigeki; Morimura, Mina; Ikebe, Takashi; Tanaka, Hiromu; Shuto, Taichi

2016-01-01

Most cases of disseminated carcinomatosis of the bone marrow (DCBM) arise from gastric cancer. DCBM from pancreatic cancer is very rare. We herein present a case of DCBM from pancreatic cancer. A 57-year-old man was referred to our hospital for severe lumbago. Laboratory data indicated that he suffered from disseminated intravascular coagulation (DIC). Non-contrast abdominal computed tomography (CT) revealed multiple bone masses but no other abnormal findings. Left iliac bone marrow biopsy revealed poorly differentiated adenocarcinoma cells. Positron emission tomography (PET)-CT showed diffuse abnormal uptake in the bones and tail of the pancreas. Contrast whole-body CT showed a tumor measuring approximately 28 mm in diameter with poor enhancement in the tail of the pancreas. The patient’s final diagnosis was pancreatic cancer located in the tail of the pancreas with diffuse bone metastases and DIC. His DCBM was thus believed to originate from the pancreatic cancer. He succumbed to the disease approximately 2 months after admission to our hospital. We herein describe a case of pancreatic cancer located in the tail of the pancreas with diffuse bone metastases and DIC, which, in our case, was DCBM. Therefore, in cases of DCBM with an unknown primary tumor, pancreatic cancer should be considered during differential diagnosis

Pancreas Center Data Profile

Science.gov (United States)

... Composite Allograft Organ Transport Living Donation Informing Patients Ethics Guidance Calendar of Events Glossary Organ Procurement and Transplantation Network Pancreas Home Data Organ Datasource ...

Tachykinins in the porcine pancreas

DEFF Research Database (Denmark)

Schmidt, P T; Tornøe, K; Poulsen, Steen Seier

2000-01-01

The localization, release, and effects of substance P and neurokinin A were studied in the porcine pancreas and the localization of substance P immunoreactive nerve fibers was examined by immunohistochemistry. The effects of electrical vagus stimulation and capsaicin infusion on tachykinin release...... and the effects of substance P and neurokinin A infusion on insulin, glucagon, somatostatin, and exocrine secretion were studied using the isolated perfused porcine pancreas with intact vagal innervation. NK-1 and NK-2 receptor antagonists were used to investigate receptor involvement. Substance P immunoreactive...

Preganglionic innervation of the pancreas islet cells in the rat

NARCIS (Netherlands)

LUITEN, PGM; TERHORST, GJ; KOOPMANS, SJ; RIETBERG, M; STEFFENS, AB

1984-01-01

The position and number of preganglionic somata innervating the insulin-secreting β-cells of the endocrine pancreas were investigated in Wistar rats. This question was approached by comparing the innervation of the pancreas of normal rats with the innervation of the pancreas in alloxan-induced

Ectopic pancreas in a giant mediastinal cyst

NARCIS (Netherlands)

Li, Wilson W.; van Boven, Wim Jan; Jurhill, Roy R.; Bonta, Peter I.; Annema, Jouke T.; de Mol, Bas A.

2016-01-01

Ectopic pancreas located in the mediastium is an extremely rare anomaly. We present a case of an ectopic pancreas located in a giant mediastinal cyst in an 18-year-old man. He presented with symptoms of dyspnea due to external compression of the cyst on the left main bronchus. Complete surgical

Developmental biology of the Psammomys obesus pancreas

DEFF Research Database (Denmark)

Vedtofte, Louise; Bödvarsdóttir, Thóra B; Karlsen, Allan E

2007-01-01

The desert gerbil Psammomys obesus, an established model of type 2 diabetes (T2D), has previously been shown to lack pancreatic and duodenal homeobox gene 1 (Pdx-1) expression. Pdx-1 deficiency leads to pancreas agenesis in both mice and humans. We have therefore further examined the pancreas of ...

Foregut cancers get new attention at CCR | Center for Cancer Research

Science.gov (United States)

The newly formed NIH Foregut Team will focus on cancers of the esophagus, stomach, pancreas, liver, bile ducts and part of the small intestine. Although these tumors are not the most common types of cancers, they are among the deadliest. Learn more...

Investigation of pancreas tumour movements and of their potential markers by four-dimensional scanography: implication for image-guided radiotherapy; etude des mouvements des tumeurs du pancreas et de leurs marqueurs potentiels par scanographie quadridimensionnelle: implication pour la radiotherapie guidee par l'image

Energy Technology Data Exchange (ETDEWEB)

Huguet, F. [Hopital Tenon, Paris (France); Yorke, E.; Davidson, M.; Zhang, Z.; Jackson, A.; Mageras, G.; Wu, A.; Goodman, K. [Memorial Sloan-Kettering Cancer Center, New York (United States)

2011-10-15

The authors report the study which aimed at quantifying pancreas tumour movements induced by breathing by using four-dimensional scanography, and at assessing the reliability of biliary prosthesis, of intra-tumor fiducials, and of an external maker as position markers of the gross tumour volume (GTV). The authors analyzed scanography images acquired during the simulation of 22 patients treated for locally advanced pancreas cancer by intensity-modulated conformational irradiation with respiratory gating. Average movements in different directions have measured. Respiratory gating limits the GTV movement amplitude by 40 to 60 per cent. GTV movements are in good correlation with that of biliary prostheses and intra-tumor fiducials. Short communication

File list: NoD.Pan.20.AllAg.Pancreas [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available NoD.Pan.20.AllAg.Pancreas mm9 No description Pancreas Pancreas ERX651337,ERX651340,...ERX651341,ERX651342 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Pan.20.AllAg.Pancreas.bed ...

File list: NoD.Pan.05.AllAg.Pancreas [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available NoD.Pan.05.AllAg.Pancreas mm9 No description Pancreas Pancreas ERX651337,ERX651340,...ERX651342,ERX651341 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Pan.05.AllAg.Pancreas.bed ...

File list: NoD.Pan.10.AllAg.Pancreas [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available NoD.Pan.10.AllAg.Pancreas mm9 No description Pancreas Pancreas ERX651337,ERX651340,...ERX651342,ERX651341 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/NoD.Pan.10.AllAg.Pancreas.bed ...

Evaluation of the pancreas by MRI

International Nuclear Information System (INIS)

Imanishi, Yoshimasa; Hou, V.Y.; Chako, A.C.; Tempany, C.M.C.; Herold, C.J.; Zerhouni, E.A.

1994-01-01

Using T1-, P- and T2-weighted images of the upper abdomen obtained on 1.5 T MRI system, 18 items on the pancreas were evaluated in 89 controls. The items included pancreas sizes on T1-weighted image, pancreatic intensity compared with those of renal cortex, subcutaneous fat tissue, liver and spleen, obliteration of pancreas margin, and diameter of pancreatic duct on all images. Normal criteria, which were determined from data in the controls, were applied to images in the 40 patients with pancreatic or peripancreatic diseases. All 4 patients with an extrapancreatic tumor had no abnormality of pancreatic intensity, pancreatic margin, and pancreatic duct on T2-weighted image, except for pancreatic sizes and intensities at tumor sites. In contrast, 34 of 36 patients with pancreatic disease had abnormalities which pathologically depended on acute and/or chronic pancreatitis. (orig.)

Perspectives and expectations of union member and non- union member teachers on teacher unions

Directory of Open Access Journals (Sweden)

Tuncer FİDAN

2015-12-01

Full Text Available Unions, which can be regarded as one of the constitutive elements of democracy, are the pressure groups in political and social fields. Unions were born out of industrial confrontations and expanded into the field of public services over time, and thus teachers – who are also public employees-, also obtained the right to establish and affiliate to unions. In this research the views of union member and non-union member teachers on the most important functions and operational effectiveness of unions, teachers’ expectations from unions and teachers’ evaluation of the solidarity, competition and cooperation between unions were determined and the perspectives of teachers on unionization were revealed. qualitative research design was used. The data needed were collected through semi-structured interviews from volunteering union member and non-union member teachers who were working in the primary and secondary schools in Ankara province and who were selected through “maximum variation sampling approach”. The data were then analyzed by using the content analysis technique. In conclusion, it was found that political ideology was the most important reason for membership of teachers’ unions. Protection and development of personal rights was found to be the most important function of teacher unions and unions were thought to be insufficient in performing those functions.

Investigation of pancreas tumour movements and of their potential markers by four-dimensional scanography: implication for image-guided radiotherapy

International Nuclear Information System (INIS)

Huguet, F.; Yorke, E.; Davidson, M.; Zhang, Z.; Jackson, A.; Mageras, G.; Wu, A.; Goodman, K.

2011-01-01

The authors report the study which aimed at quantifying pancreas tumour movements induced by breathing by using four-dimensional scanography, and at assessing the reliability of biliary prosthesis, of intra-tumor fiducials, and of an external maker as position markers of the gross tumour volume (GTV). The authors analyzed scanography images acquired during the simulation of 22 patients treated for locally advanced pancreas cancer by intensity-modulated conformational irradiation with respiratory gating. Average movements in different directions have measured. Respiratory gating limits the GTV movement amplitude by 40 to 60 per cent. GTV movements are in good correlation with that of biliary prostheses and intra-tumor fiducials. Short communication

Computed tomography and ultrasound of the normal pancreas

International Nuclear Information System (INIS)

Kolmannskog, F.; Swensen, T.; Vatn, M.H.; Larsen, S.

1982-01-01

Computed tomography (CT) and ultrasound (US) were performed on 47 patients with a normal pancreas. CT was a significantly better method than US to demonstrate the pancreatic body and tail. The pancreatic head was also shown more often using CT than US, but this difference was not statistically significant. The diameters of the different parts of the pancreas measured at CT were significantly larger than measured at US. The explanation is most probably that the widths of the splenic and superior mesenteric veins are added to the diameters of the pancreas measured at CT, while using US, these vessels are clearly differentiated from the pancreatic tissue. US was a significantly better technique than CT to register the vascular structures surrounding the pancreas, except from the left renal vein, which was more often demonstrated at CT. (Auth.)

Testosterone biotransformation by the isolated perfused canine pancreas

International Nuclear Information System (INIS)

Fernandez-del Castillo, C.; Diaz-Sanchez, V.; Varela-Fascinetto, G.; Altamirano, A.; Odor-Morales, A.; Lopez-Medrano, R.M.; Robles-Diaz, G.

1991-01-01

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

Testosterone biotransformation by the isolated perfused canine pancreas

Energy Technology Data Exchange (ETDEWEB)

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

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.

The Human Pancreas Proteome Defined by Transcriptomics and Antibody-Based Profiling

Science.gov (United States)

Fagerberg, Linn; Hallström, Björn M.; Schwenk, Jochen M.; Uhlén, Mathias; Korsgren, Olle; Lindskog, Cecilia

2014-01-01

The pancreas is composed of both exocrine glands and intermingled endocrine cells to execute its diverse functions, including enzyme production for digestion of nutrients and hormone secretion for regulation of blood glucose levels. To define the molecular constituents with elevated expression in the human pancreas, we employed a genome-wide RNA sequencing analysis of the human transcriptome to identify genes with elevated expression in the human pancreas. This quantitative transcriptomics data was combined with immunohistochemistry-based protein profiling to allow mapping of the corresponding proteins to different compartments and specific cell types within the pancreas down to the single cell level. Analysis of whole pancreas identified 146 genes with elevated expression levels, of which 47 revealed a particular higher expression as compared to the other analyzed tissue types, thus termed pancreas enriched. Extended analysis of in vitro isolated endocrine islets identified an additional set of 42 genes with elevated expression in these specialized cells. Although only 0.7% of all genes showed an elevated expression level in the pancreas, this fraction of transcripts, in most cases encoding secreted proteins, constituted 68% of the total mRNA in pancreas. This demonstrates the extreme specialization of the pancreas for production of secreted proteins. Among the elevated expression profiles, several previously not described proteins were identified, both in endocrine cells (CFC1, FAM159B, RBPJL and RGS9) and exocrine glandular cells (AQP12A, DPEP1, GATM and ERP27). In summary, we provide a global analysis of the pancreas transcriptome and proteome with a comprehensive list of genes and proteins with elevated expression in pancreas. This list represents an important starting point for further studies of the molecular repertoire of pancreatic cells and their relation to disease states or treatment effects. PMID:25546435

Multi-slice CT features of annular pancreas in neonates

International Nuclear Information System (INIS)

He Mingqing; Zhu Youzhi; Hu Kefei; Yin Chuangao; Hu Jun; Wang Song; Li Xu; Lu Zhongbin; Wang Yue; Liu Xiang

2013-01-01

Objective: To investigate the MSCT manifestations and their values in the diagnosis of annular pancreas in neonates. Methods: Retrospective analysis of clinical and CT findings in 27 cases with surgery-proved annular pancreas in neonates was made. The unenhanced and contrast-enhanced CT images were obtained in 20 patients. Two experienced radiologists determined the site and degree of obstruction, the relationship between the head of the pancreas and the obstruction point, and the surrounding tissue structure. Results: The direct signs included the fluid-filled or gas-filled bowel in the head of pancreas in 4 cases, the enhancement of surrounding soft tissue as enhanced pancreas in 17 cases, disappearance of the fat gap between the intestinal wall and the annular pancreas in 17 cases. The indirect signs included intestinal obstruction in 20 cases, 'single-bubble sign' in 2 cases, 'double-bubble sign' in 18 cases, the distal bowel without gas in 5 cases, small amount of gas in the distal bowel in 15 cases. In 12 of 18 cases showing 'double-bubble sign', the ratio of duodenal bubble diameter (Dd) to stomach bubble diameter (Ds)was over 1.0. The site of obstruction was located in the descending duodenum in 20 cases. The form of obstructed point presented with 'nipple sign' in 15 cases, with 'the mouse tail' in 5 cases. The expansion bowel was located in the head of pancreas in 1 case. Gas was found in the pancreatic duct in 1 case, and 'swirl sign' was shown in 2 cases. Conclusions: MSCT combined with three-dimensional reconstruction techniques can clearly demonstrate the annular pancreas' s shape, the site and degree of obstruction and other malformations. It can provide important information for clinical treatment. (authors)

Reconstructed coronal views of CT and isotopic images of the pancreas

International Nuclear Information System (INIS)

Kasuga, Toshio; Kobayashi, Toshio; Nakanishi, Fumiko

1980-01-01

To compare functional images of the pancreas by scintigraphy with morphological views of the pancreas by CT, CT coronal views of the pancreas were reconstructed. As CT coronal views were reconstructed from the routine scanning, there was a problem in longitudinal spatial resolution. However, almost satisfactory total images of the pancreas were obtained by improving images adequately. In 27 patients whose diseases had been confirmed, it was easy to compare pancreatic scintigrams with pancreatic CT images by using reconstructed CT coronal views, and information which had not been obtained by original CT images could be obtained by using reconstructed CT coronal views. Especially, defects on pancreatic images and the shape of pancreas which had not been visualized clearly by scintigraphy alone could be visualized by using reconstructed CT coronal views of the pancreas. (Tsunoda, M.)

Solid and papillary neoplasm of the pancreas

DEFF Research Database (Denmark)

Jørgensen, L J; Hansen, A B; Burcharth, F

1992-01-01

In two cases of solid and papillary neoplasm of the pancreas (SPN), positive staining for argyrophil granules, chromogranin-A, neuron-specific enolase, chymotrypsin, alpha 1-antitrypsin, vimentin, cytokeratin, and estrogen receptors was present. Ultrastructurally, neurosecretory as well as zymoge......In two cases of solid and papillary neoplasm of the pancreas (SPN), positive staining for argyrophil granules, chromogranin-A, neuron-specific enolase, chymotrypsin, alpha 1-antitrypsin, vimentin, cytokeratin, and estrogen receptors was present. Ultrastructurally, neurosecretory as well...... as zymogenlike granules were demonstrated. Measurements of mean nuclear volume and volume-corrected mitotic index discriminated between SPN and well-differentiated ductal adenocarcinoma of the pancreas, with notably lower values being seen in SPN. Silver-stained nucleolar organizer region counts showed wide...

Agenesis of pancreas

DEFF Research Database (Denmark)

Voldsgaard, P; Kryger-Baggesen, N; Lisse, I

1994-01-01

Complete agenesis of pancreas is a rare and lethal condition. Four cases have previously been reported in combination with other malformations, such as severe intrauterine growth retardation, hyperglycaemia and meconium ileus. We report a case of pancreatic agenesis as a single anomaly. The child...

Fibromyxoid sarcoma of the pancreas

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Čolović Radoje

2008-01-01

Full Text Available Introduction Fibromyxoid sarcoma is a rare mesenchymal neoplasm, usually appearing in the soft tissue of the extremities, less frequently in the groin, trunk, neck, and upper extremities. Within the abdomen, the tumour is usually localised within the retroperitoneum. Case OutlineWe present a 56-year-old woman in whom, during the routinely performed investigation for atacks of choking with lots of bronchial secretion, and arterial hypertension, an ultrasonographer found a tumour within the head of the pancreas 6×6 cm in diameter. At operation, a dark pink, lobulated soft tumour, surrounded by a tiny capsule, clearly different from the completely normal pancreatic tissue of the posterior side of the head of the pancreas, was easily and ideally excised.The postoperative recovery was stormy. She developed postoperative pancreatitis, temporary biliary and duodenal fistula, which all settled by conservative treatment. The histology of the 80 g weighing tumour showed a circumscribed fibromyxoid sarcoma of low malignancy. Immunohistochemistry showed diffuse vimentin and CD34 strong positivity, as well as focal anti-SMA and anti-EMA immunopositivity. Six months after surgery, she died with signs of cerebrovascular insult, asthmatic status, and recurrent suppurative abdominal fistula, probably related to the previous pancreatitis. Ultrasonography showed a possible liver secondary. The exact cause of death was not confirmed as the autopsy was refused by the family. Conclusion Primary sarcomas of the pancreas are very rare, but should be considered in differential diagnosis of pancreatic neoplasms. To the best of our knowledge, there has been no previously described fibromyxoid sarcoma of the pancreas. .

Novel circulatory connection from the acupoint Zhong Wan(CV12 to pancreas

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Minsoo Kim

2008-03-01

Full Text Available Objectives : Demonstrating a novel circulatory path from the acupoint(CV12 to the pancreas. Method : Alcian blue(1% solution, 20μl, pH 7.4 was injected into the acupoint(CV12. Two hours later the surfaces of internal organs were observed by using a stereomicroscope. Results : Alcian blue arrived and colored the omental fat band(OFB on the pancreas. The OFB connected the head and tail of the pancreas, the pancreas and the spleen, and the pancreas and the stomach. Conclusion : The existence of a novel circulatory path from the acupoint CV12 to the pancreas and its OFB was demonstrated.

Pig Pancreas Anatomy: Implications for Pancreas Procurement, Preservation, and Islet Isolation

Science.gov (United States)

Ferrer, Joana; Scott, William E; Weegman, Bradley P; Suszynski, Thomas M; Sutherland, David E R; Hering, Bernhard J; Papas, Klearchos K

2009-01-01

Background Islet transplantation is emerging as a treatment option for selected patients with type 1 diabetes. The limited human islet supply from cadavers and poor islet yield and quality remain substantial impediments to progress in the field. Use of porcine islets holds great promise for large-scale application of islet transplantation. Consistent isolation of porcine islets is dependent on advances in pancreas procurement and preservation, and islet isolation requiring detailed knowledge of the porcine pancreatic anatomy. The primary aim of this study was to describe the vascular and ductal anatomy of the porcine pancreas in order to guide and improve organ preservation and enzyme perfusion. Methods Pancreata were removed by en bloc viscerectomy from 65 female Landrace pigs. Results 15% of organs exhibited inconsistent vascular branching from the celiac trunk. All organs had uniform patterns of branching at the superior mesenteric artery. The superior and inferior mesenteric veins (IMV) merged to become the portal vein in all but one case in which the IMV drained into the splenic vein. 97% of pancreata had three lobes: duodenal (DL), connecting (CL), and splenic (SL); 39% demonstrated ductal communication between the CL and the other two lobes; 50% had ductal communication only between the CL and DL; and 11% presented other types of ductal delineation. Conclusions Accounting for the variations in vascular and ductal anatomy, as detailed in this study, will facilitate development of protocols for preservation, optimal enzyme administration, and pancreas distention and digestion, and ultimately lead to substantial improvements in isolation outcomes. PMID:19077881

Rat pancreas secretes particulate ecto-nucleotidase CD39

DEFF Research Database (Denmark)

Sørensen, Christiane Elisabeth; Amstrup, Jan; Rasmussen, Hans N

2003-01-01

In exocrine pancreas, acini release ATP and the excurrent ducts express several types of purinergic P2 receptors. Thereby, ATP, or its hydrolytic products, might play a role as a paracrine regulator between acini and ducts. The aim of the present study was to elucidate whether this acinar......-ductal signalling is regulated by nucleotidase(s), and to characterize and localize one of the nucleotidases within the rat pancreas. Using RT-PCR and Western blotting we show that pancreas expresses the full length ecto-nucleoside triphosphate diphosphohydrolase, CD39. Immunofluorescence shows CD39 localization...... relocalizes in clusters towards the lumen and is secreted. As a result, pancreatic juice collected from intact pancreas stimulated with CCK-8 contained nucleotidase activity, including that of CD39, and no detectable amounts of ATP. Anti-CD39 antibodies detected the full length (78 kDa) CD39 in pancreatic...

Feasibility and safety of electrochemotherapy (ECT in the pancreas: a pre-clinical investigation

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Girelli Roberto

2015-06-01

Full Text Available Background. Pancreatic ductal adenocarcinoma (PDAC is a lethal disease generally refractory to standard chemotherapeutic agents; therefore improvements in anticancer therapies are mandatory. A major determinant of therapeutic resistance in PDAC is the poor drug delivery to neoplastic cells, mainly due to an extensive fibrotic reaction. Electroporation can be used in vivo to increase cancer cells’ local uptake of chemotherapeutics (electrochemotherapy, ECT, thus leading to an enhanced tumour response rate. In the present study, we evaluated the in vivo effects of reversible electroporation in normal pancreas in a rabbit experimental model. We also tested the effect of electroporation on pancreatic cancer cell lines in order to evaluate their increased sensitivity to chemotherapeutic agents.

In Vivo Senescence in the Sbds-Deficient Murine Pancreas: Cell-Type Specific Consequences of Translation Insufficiency.

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Marina E Tourlakis

2015-06-01

Full Text Available Genetic models of ribosome dysfunction show selective organ failure, highlighting a gap in our understanding of cell-type specific responses to translation insufficiency. Translation defects underlie a growing list of inherited and acquired cancer-predisposition syndromes referred to as ribosomopathies. We sought to identify molecular mechanisms underlying organ failure in a recessive ribosomopathy, with particular emphasis on the pancreas, an organ with a high and reiterative requirement for protein synthesis. Biallelic loss of function mutations in SBDS are associated with the ribosomopathy Shwachman-Diamond syndrome, which is typified by pancreatic dysfunction, bone marrow failure, skeletal abnormalities and neurological phenotypes. Targeted disruption of Sbds in the murine pancreas resulted in p53 stabilization early in the postnatal period, specifically in acinar cells. Decreased Myc expression was observed and atrophy of the adult SDS pancreas could be explained by the senescence of acinar cells, characterized by induction of Tgfβ, p15(Ink4b and components of the senescence-associated secretory program. This is the first report of senescence, a tumour suppression mechanism, in association with SDS or in response to a ribosomopathy. Genetic ablation of p53 largely resolved digestive enzyme synthesis and acinar compartment hypoplasia, but resulted in decreased cell size, a hallmark of decreased translation capacity. Moreover, p53 ablation resulted in expression of acinar dedifferentiation markers and extensive apoptosis. Our findings indicate a protective role for p53 and senescence in response to Sbds ablation in the pancreas. In contrast to the pancreas, the Tgfβ molecular signature was not detected in fetal bone marrow, liver or brain of mouse models with constitutive Sbds ablation. Nevertheless, as observed with the adult pancreas phenotype, disease phenotypes of embryonic tissues, including marked neuronal cell death due to apoptosis

In Vivo Senescence in the Sbds-Deficient Murine Pancreas: Cell-Type Specific Consequences of Translation Insufficiency

Science.gov (United States)

Tourlakis, Marina E.; Zhang, Siyi; Ball, Heather L.; Gandhi, Rikesh; Liu, Hongrui; Zhong, Jian; Yuan, Julie S.; Guidos, Cynthia J.; Durie, Peter R.; Rommens, Johanna M.

2015-01-01

Genetic models of ribosome dysfunction show selective organ failure, highlighting a gap in our understanding of cell-type specific responses to translation insufficiency. Translation defects underlie a growing list of inherited and acquired cancer-predisposition syndromes referred to as ribosomopathies. We sought to identify molecular mechanisms underlying organ failure in a recessive ribosomopathy, with particular emphasis on the pancreas, an organ with a high and reiterative requirement for protein synthesis. Biallelic loss of function mutations in SBDS are associated with the ribosomopathy Shwachman-Diamond syndrome, which is typified by pancreatic dysfunction, bone marrow failure, skeletal abnormalities and neurological phenotypes. Targeted disruption of Sbds in the murine pancreas resulted in p53 stabilization early in the postnatal period, specifically in acinar cells. Decreased Myc expression was observed and atrophy of the adult SDS pancreas could be explained by the senescence of acinar cells, characterized by induction of Tgfβ, p15Ink4b and components of the senescence-associated secretory program. This is the first report of senescence, a tumour suppression mechanism, in association with SDS or in response to a ribosomopathy. Genetic ablation of p53 largely resolved digestive enzyme synthesis and acinar compartment hypoplasia, but resulted in decreased cell size, a hallmark of decreased translation capacity. Moreover, p53 ablation resulted in expression of acinar dedifferentiation markers and extensive apoptosis. Our findings indicate a protective role for p53 and senescence in response to Sbds ablation in the pancreas. In contrast to the pancreas, the Tgfβ molecular signature was not detected in fetal bone marrow, liver or brain of mouse models with constitutive Sbds ablation. Nevertheless, as observed with the adult pancreas phenotype, disease phenotypes of embryonic tissues, including marked neuronal cell death due to apoptosis, were determined to

Lymphoepithelial cyst of the pancreas: a case report

International Nuclear Information System (INIS)

Joo, Seung Ho; Kim, Myeong Jin; Kim, Ki Whang; Park, Young Nyun; Shim, Hyp Sup; Lim, Joon Seok

2005-01-01

We present a case of lymphoepithelial cyst of the pancreas. The cyst showed moderate echogenicity, mimicking a solid lesion on ultrasonography (US), and had a cystic appearance on computed tomography (CT). This ambivalent finding may be a distinctive feature of lymphoepithelial cysts of the pancreas

Synchronous Onset of Breast and Pancreatic Cancers: Results of Germline and Somatic Genetic Analysis

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Michael Castro

2016-07-01

Full Text Available Background: Synchronous cancers have occasionally been detected at initial diagnosis among patients with breast and ovarian cancer. However, simultaneous coexistence and diagnosis of breast and pancreas cancer has not previously been reported. Case Report: Paternal transmission of a germline BRCA2 mutation to a patient who was diagnosed at age 40 with locally advanced breast and pancreas cancer is presented. Somatic genomic analysis of both cancers with next-generation DNA sequencing confirmed the germline result and reported a variety of variants of unknown significance alterations, of which two were present in both the breast and pancreas cancers. Discussion: The possibility that genomic alterations could have been responsible for modulating the phenotypic or clinical expression of this rare presentation is considered. The authors call attention to the practice of privatizing the clinicogenetic information gained from genetic testing and call for health policy that will facilitate sharing in order to advance the outcomes of patients diagnosed with hereditary cancers.

Common hepatic artery aneurysm: Pseudopseudocyst of the pancreas

International Nuclear Information System (INIS)

Shultz, S.; Druy, E.M.; Friedman, A.C.

1985-01-01

The preoperative diagnosis of hepatic artery aneurysm is uncommon, and its presentation as a pancreatic mass is rare. Because of its great potential for rupture early diagnosis and treatment is essential. The authors report two cases of aneurysms of the common hepatic artery, which on CT presented as a cystic mass in the head of the pancreas. These cases illustrate the importance of using 10-mm serial sections through the pancreas after a bolus injection of intravenous contrast material in order to allow distinction between hepatic artery aneurysm and other, more common, cystic masses of the pancreas

Endoscopic ultrasound-guided radiofrequency ablation of the pancreas

DEFF Research Database (Denmark)

Silviu, Ungureanu Bogdan; Daniel, Pirici; Claudiu, Mărgăritescu

2015-01-01

ultrasound (EUS)-guided radiofrequency ablation (RFA) probe through a 19G needle in order to achieve a desirable necrosis area in the pancreas. Radiofrequency ablation of the head of the pancreas was performed on 10 Yorkshire pigs with a weight between 25 kg and 35 kg and a length of 40-70 cm. Using an EUS...... analysis revealed increased values of amylase, alkaline phosphatase, and gamma-glutamyl transpeptidase on the 3rd day but a decrease on the 5th day. After necropsy and isolation of the pancreas, the ablated area was easily found, describing a solid necrosis. The pathological examination revealed...

Diagnosis and surgical therapy of pancreas tumors

International Nuclear Information System (INIS)

Heid, A.

1981-01-01

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-pancreaticography (ERCP) bring the best diagnostic results. In case of pancreatogenic hyperinsulinism a selective angiography should be carried out in any case for an exact presurgical localisation. (orig./MG) [de

Endocrine pancreas development at weaning in goat kids

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Fabia Rosi

2010-01-01

Full Text Available Eighteen three-day old Saanen goat kids were divided into MILK and WEAN groups. MILK kids received goat milk to age 48 days; WEAN kids were initially fed milk but started weaning at 25 days and were completely weaned by 40 days. Total intake per group was recorded daily. On day 25, 40 and 48, body weights were recorded, and plasma samples were taken and analyzed for glucose, free amino-acids and insulin. On day 48, all animals were slaughtered and pancreas samples were analyzed for total DNA and RNA content. Histological sections of pancreas were examined by light microscope and images analyzed by dedicated software. Seven days after the beginning of the weaning program, dry matter intake in the WEAN group began to decrease compared to the MILK one. Nonetheless, body weight did not differ throughout the study period. Weaning significantly decreased plasma levels of glucose, amino-acids and insulin. No difference was observed in pancreatic DNA and RNA content. Histological analysis of pancreas showed that the size of pancreatic islets was not different, but islet number per section was lower in the pancreas of WEAN animals. In conclusion, weaning affects glucose and amino-acid metabolism and influences endocrine pancreas activity and morphology.

Radical antegrade modular pancreatosplenectomy for adenocarcinomaof the body of the pancreas in a patient with portal annular pancreas, aberrant hepatic artery, and absence of the celiac trunk: A case report.

Science.gov (United States)

Yuan, Hao; Wu, Pengfei; Chen, Jianmin; Lu, Zipeng; Chen, Lei; Wei, Jishu; Guo, Feng; Cai, Baobao; Yin, Jie; Xu, Dong; Jiang, Kuirong; Miao, Yi

2017-12-01

Portal annular pancreas is a rare anatomic variation, where the uncinated process of the pancreas connects with the dorsal pancreas and the pancreas tissue encases the portal vein (PV), superior mesenteric vein (SMV) or splenic vein (SV). Malignancies are quite uncommon in the patients, who have an annular pancreas especially portal annular pancreas. Ectopic common hepatic artery and absence of the celiac trunk (CT) are the other infrequent abnormalities. A 74-year-old man suffered from upper abdominal and back pain. Contrast enhanced computed tomography indicated a low-density mass in the body of the pancreas. Pathological report showed adenocarcinoma of the body of pancreas after radical antegrade modular pancreatosplenectomy (RAMPS). In the operation, we found the superior vein and portal vein was surrounded by the pancreatic tissue. The left gastric artery and splenic artery originated respectively from abdominal aorta, and celiac trunk was not viewed. In addition, the common hepatic artery was a branch from the superior mesenteric artery. In general, this is a novel clinical case of pancreatic carcinoma happening in the portal annular pancreas which was accompanied with aberrant hepatic artery and absence of the celiac trunk at the same time. Confronted with the pancreatic neoplasms, the possibility of coexistent annular pancreas and arterial variations should be considered.

Elastography for the pancreas: Current status and future perspective.

Science.gov (United States)

Kawada, Natsuko; Tanaka, Sachiko

2016-04-14

Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas.

Elastography for the pancreas: Current status and future perspective

Science.gov (United States)

Kawada, Natsuko; Tanaka, Sachiko

2016-01-01

Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas. PMID:27076756

Exenatide Induces Impairment of Autophagy Flux to Damage Rat Pancreas.

Science.gov (United States)

Li, Zhiqiang; Huang, Lihua; Yu, Xiao; Yu, Can; Zhu, Hongwei; Li, Xia; Han, Duo; Huang, Hui

2017-01-01

The study aimed to explore the alteration of autophagy in rat pancreas treated with exenatide. Normal Sprague-Dawley rats and diabetes-model rats induced by 2-month high-sugar and high-fat diet and streptozotocin injection were subcutaneously injected with exenatide, respectively, for 10 weeks, with homologous rats treated with saline as control. Meanwhile, AR42J cells, pancreatic acinar cell line, were cultured with exenatide at doses of 5 pM for 3 days. The pancreas was disposed, and several sections were stained with hematoxylin-eosin. Immunohistochemistry was used to measure the expressions of glucagon-like peptide 1 receptor (GLP-1R) and cysteine-aspartic acid protease-3 in rat pancreas, and Western blot was used to test the expressions of GLP-1R, light chain 3B-I and -II, and p62 in rat pancreas and AR42J cells. The data were expressed as mean (standard deviation) and analyzed by unpaired Student's t-test. Exenatide can induce pathological changes in rat pancreas. The GLP-1R, p62, light chain 3B-II, and cysteine-aspartic acid protease-3 in rat pancreas and AR42J cells treated with exenatide were significantly overexpressed. Exenatide can activate and upregulate its receptor, GLP-1R, then impair autophagy flux and activate apoptosis in the pancreatic acinar cell, thus damaging rat pancreas.

Cystic lesion of pancreas - Intraductal papillary mucinous neoplasm

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Rajiv Baijal

2013-01-01

Full Text Available Intraductal papillary mucinous neoplasm (IPMN of the pancreas is an intraductal mucin-producing epithelial neoplasm that arises from the main and/or branched pancreatic duct. It usually presents as cystic lesion of pancreas. There are well known differential diagnosis of cystic pancreatic lesion. Pancreatic cystic neoplasms are detected at an increasing frequency due to an increased use of abdominal imaging. The diagnosis and treatment of intraductal papillary mucinous tumors (IPMN of the pancreas has evolved over the past decade. IPMN represents a spectrum of disease, ranging from benign to malignant lesions, making the early detection and characterization of these lesions important. Definitive management is surgical resection for appropriate candidates, as benign lesions harbor malignant potential. IPMN has a prognosis, which is different from adenocarcinoma of the pancreas. We report a case of a 58-year-old male with intraductal papillary neoplasm involving main duct and side branches presenting to us with clinical symptoms of chronic pancreatitis with obstructive jaundice and cholangitis treated surgically.

Stochastic Differential Equations in Artificial Pancreas Modelling

DEFF Research Database (Denmark)

Duun-Henriksen, Anne Katrine

Type 1 diabetes accounts for approximately 5% of the total diabetes population. It is caused by the destruction of insulin producing β-cells in the pancreas. Various treatment strategies are available today, some of which include advanced technological devices such as an insulin pump and a contin......Type 1 diabetes accounts for approximately 5% of the total diabetes population. It is caused by the destruction of insulin producing β-cells in the pancreas. Various treatment strategies are available today, some of which include advanced technological devices such as an insulin pump...... of the insulin pump and the CGM has paved the way for a fully automatic treatment regime, the artificial pancreas. The idea is to connect the CGM with the insulin pump via a control algorithm running on e.g. the patients smart phone. The CGM observations are sent to the smart phone and based on this information...... of the system directly. The purpose of this PhD-project was to investigate the potential of SDEs in the artificial pancreas development. Especially, the emerging continuous monitoring of glucose levels makes SDEs highly applicable to this field. The current thesis aims at demonstrating and discussing...

PPARγ regulates exocrine pancreas lipase.

Science.gov (United States)

Danino, Hila; Naor, Ronny Peri-; Fogel, Chen; Ben-Harosh, Yael; Kadir, Rotem; Salem, Hagit; Birk, Ruth

2016-12-01

Pancreatic lipase (triacylglycerol lipase EC 3.1.1.3) is an essential enzyme in hydrolysis of dietary fat. Dietary fat, especially polyunsaturated fatty acids (PUFA), regulate pancreatic lipase (PNLIP); however, the molecular mechanism underlying this regulation is mostly unknown. As PUFA are known to regulate expression of proliferator-activated receptor gamma (PPARγ), and as we identified in-silico putative PPARγ binding sites within the putative PNLIP promoter sequence, we hypothesized that PUFA regulation of PNLIP might be mediated by PPARγ. We used in silico bioinformatics tools, reporter luciferase assay, PPARγ agonists and antagonists, PPARγ overexpression in exocrine pancreas AR42J and primary cells to study PPARγ regulation of PNLIP. Using in silico bioinformatics tools we mapped PPARγ binding sites (PPRE) to the putative promoter region of PNLIP. Reporter luciferase assay in AR42J rat exocrine pancreas acinar cells transfected with various constructs of the putative PNLIP promoter showed that PNLIP transcription is significantly enhanced by PPARγ dose-dependently, reaching maximal levels with multi PPRE sites. This effect was significantly augmented in the presence of PPARγ agonists and reduced by PPARγ antagonists or mutagenesis abrogating PPRE sites. Over-expression of PPARγ significantly elevated PNLIP transcript and protein levels in AR42J cells and in primary pancreas cells. Moreover, PNLIP expression was up-regulated by PPARγ agonists (pioglitazone and 15dPGJ2) and significantly down-regulated by PPARγ antagonists in non-transfected rat exocrine pancreas AR42J cell line cells. PPARγ transcriptionally regulates PNLIP gene expression. This transcript regulation resolves part of the missing link between dietary PUFA direct regulation of PNLIP. Copyright © 2016 Elsevier B.V. All rights reserved.

Physiology of fish endocrine pancreas.

Science.gov (United States)

Plisetskaya, E M

1989-06-01

From the very beginning of physiological studies on the endocine pancreas, fish have been used as experimental subjects. Fish insulin was one of the first vertebrate insulins isolated and one of the first insulins whose primary and then tertiary structures were reported. Before a second pancreatic hormone, glucagon, was characterized, a physiologically active 'impurity', similar to that in mammalian insulin preparations, was found in fish insulins.Fish have become the most widely used model for studies of biosynthesis and processing of the pancreatic hormones. It seems inconceivable, therefore, that until the recent past cod and tuna insulins have been the only purified piscine islet hormones available for physiological experiments. The situation has changed remarkably during the last decade.In this review the contemporary status of physiological studies on the fish pancreas is outlined with an emphasis on the following topics: 1) contents of pancreatic peptides in plasma and in islet tissue; 2) actions of piscine pancreatic hormones in fish; 3) specific metabolic consequences of an acute insufficiency of pancreatic peptides; 4) functional interrelations among pancreatic peptides which differ from those of mammals. The pitfalls, lacunae and the perspectives of contemporary physiological studies on fish endocrine pancreas are outlined.

Trade Union Organisers in Trade Union Organising Strategies: building workplace unionism or reinforcing bureaucracy

OpenAIRE

Looker, Gerard

2015-01-01

This thesis considers the role of union full time officers in union organising strategies. Two decades of promoting union organising influenced by models developed by the AFL-CIO, has failed to arrest the decline of UK trade unions let alone produce evidence of renewal. Focusing mainly on one region in the UKs largest public sector trade union, Unison, the research provides for a detailed account of how organising strategies affect union work, presenting thick and deep data from full time off...

Disorders of the pediatric pancreas: imaging features

International Nuclear Information System (INIS)

Nijs, Els; Callahan, Michael J.; Taylor, George A.

2005-01-01

The purpose of this manuscript is to provide an overview of the normal development of the pancreas as well as pancreatic pathology in children. Diagnostic imaging plays a major role in the evaluation of the pancreas in infants and children. Familiarity with the range of normal appearance and the diseases that commonly affect this gland is important for the accurate and timely diagnosis of pancreatic disorders in the pediatric population. Normal embryology is discussed, as are the most common congenital anomalies that occur as a result of aberrant development during embryology. These include pancreas divisum, annular pancreas, agenesis of the dorsal pancreatic anlagen and ectopic pancreatic tissue. Syndromes that can manifest pancreatic pathology include: Beckwith Wiedemann syndrome, von Hippel-Lindau disease and autosomal dominant polycystic kidney disease. Children and adults with cystic fibrosis and Shwachman-Diamond syndrome frequently present with pancreatic insufficiency. Trauma is the most common cause of pancreatitis in children. In younger children, unexplained pancreatic injury must always alert the radiologist to potential child abuse. Pancreatic pseudocysts are a complication of trauma, but can also be seen in the setting of acute or chronic pancreatitis from other causes. Primary pancreatic neoplasms are rare in children and are divided into exocrine tumors such as pancreatoblastoma and adenocarcinoma and into endocrine or islet cell tumors. Islet cell tumors are classified as functioning (insulinoma, gastrinoma, VIPoma and glucagonoma) and nonfunctioning tumors. Solid-cystic papillary tumor is probably the most common pancreatic tumor in Asian children. Although quite rare, secondary tumors of the pancreas can be associated with certain primary malignancies. (orig.)

Disorders of the pediatric pancreas: imaging features

Energy Technology Data Exchange (ETDEWEB)

Nijs, Els [University Hospital Gasthuisberg, Department of Radiology, Leuven (Belgium); Callahan, Michael J.; Taylor, George A. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States)

2005-04-01

The purpose of this manuscript is to provide an overview of the normal development of the pancreas as well as pancreatic pathology in children. Diagnostic imaging plays a major role in the evaluation of the pancreas in infants and children. Familiarity with the range of normal appearance and the diseases that commonly affect this gland is important for the accurate and timely diagnosis of pancreatic disorders in the pediatric population. Normal embryology is discussed, as are the most common congenital anomalies that occur as a result of aberrant development during embryology. These include pancreas divisum, annular pancreas, agenesis of the dorsal pancreatic anlagen and ectopic pancreatic tissue. Syndromes that can manifest pancreatic pathology include: Beckwith Wiedemann syndrome, von Hippel-Lindau disease and autosomal dominant polycystic kidney disease. Children and adults with cystic fibrosis and Shwachman-Diamond syndrome frequently present with pancreatic insufficiency. Trauma is the most common cause of pancreatitis in children. In younger children, unexplained pancreatic injury must always alert the radiologist to potential child abuse. Pancreatic pseudocysts are a complication of trauma, but can also be seen in the setting of acute or chronic pancreatitis from other causes. Primary pancreatic neoplasms are rare in children and are divided into exocrine tumors such as pancreatoblastoma and adenocarcinoma and into endocrine or islet cell tumors. Islet cell tumors are classified as functioning (insulinoma, gastrinoma, VIPoma and glucagonoma) and nonfunctioning tumors. Solid-cystic papillary tumor is probably the most common pancreatic tumor in Asian children. Although quite rare, secondary tumors of the pancreas can be associated with certain primary malignancies. (orig.)

Mn-DPDP, the first contrast agent for the pancreas

International Nuclear Information System (INIS)

Gehl, H.B.; Vorwerk, D.; Klose, K.C.; Raber, H.; Guenther, R.W.

1990-01-01

Mn-DPDP, known as a contrast agent for the hepatobiliary system, shows signal intensity increase of the pancreas as well. This paper describes the extent of signal intensity increase in the pancreas as a function of time. Six healthy volunteers were imaged with a 1.5-T MR unit using a T1-weighted gradient-echo sequence. Acquisitions were taken in 3-minute intervals for the first 45 minutes, followed by intervals of 30 minutes for 7 hours after infusion of Mn-DPDP. As a special formulation, 10 μmol per kg Mn-DPDP were infused. The enhancement of the head and the tail of the pancreas were measured and plotted as a function of time; the percentage increase in pancreas signal intensity was calculated and compared with the increase in liver signal intensity

The economics of pancreas surgery.

Science.gov (United States)

Vollmer, Charles M

2013-06-01

Pancreas surgery is a paradigm for high-acuity surgical specialization. Given the current intrigue over containing health care expenditures, pancreas surgery provides an ideal model to investigate the cost of care. This article explores the economics of this field from literature accrued over the last 2 decades. The cost of performing a pancreatic resection is established and then embellished with a discussion of the effects of clinical care paths. Then the influence of complications on costs is explored. Next, cost is investigated as an emerging outcome metric regarding variations in pancreatic surgical care. Finally, the societal-level fiscal impact is considered. Copyright © 2013 Elsevier Inc. All rights reserved.

THE REDUCED CANINE PANCREAS TO STUDY THE EFFECTS OF INTRAOPERATIVE RADIOTHERAPY

NARCIS (Netherlands)

HEIJMANS, HJ; MEHTA, D; KLEIBEUKER, JH; SLUITER, WJ; HOEKSTRA, HJ

1993-01-01

A canine model is described to study the tolerance of the pancreas to intra-operative radiotherapy (IORT). The canine pancreas is a horseshoe-shaped organ. To create a homogeneous delivery of IORT to the whole pancreas surgical manipulation is necessary which may induce pancreatitis. A resection of

CLINICAL AND FUNCTIONAL FEATURES OF PANCREAS STATE IN RHEUMATOID ARTHRITIS

Directory of Open Access Journals (Sweden)

O. O. Basieva

2000-01-01

Full Text Available Aim of study: complex pancreas study in rheumatoid arthritis (RA. Material and methods: 120 RA pts were examined clinically Pancreas US-and biochemical study (level of a-amylase and lipase of blood serum by kinetic-calorimetric method was performed in this grouh. Results: 50.8% of pts demonstrated increase of pancreas echo, in 23.3%- widened Wirsung s duct, in 45%- single small focal indurations, more often in the body and cauda pancreatis. Decrease of lipolitic and amylolytic pancreas activity is characteristic for RA, especially in systemic process and long-term disease. Clinical and functional disturbances are connected with morphological changes.

Functional imaging of the pancreas. Image processing techniques and clinical evaluation

Energy Technology Data Exchange (ETDEWEB)

Nakanishi, Fumiko

1984-02-01

An image processing technique for functional imaging of the pancreas was developed and is here reported. In this paper, clinical efficacy of the technique for detecting pancreatic abnormality is evaluated in comparison with conventional pancreatic scintigraphy and CT. For quantitative evaluation, functional rate, i.e. the rate of normal functioning pancreatic area, was calculated from the functional image and subtraction image. Two hundred and ninety-five cases were studied using this technique. Conventional image had a sensitivity of 65% and a specificity of 78%, while the use of functional imaging improved sensitivity to 88% and specificity to 88%. The mean functional rate in patients with pancreatic disease was significantly lower (33.3 +- 24.5 in patients with chronic pancreatitis, 28.1 +- 26.9 in patients with acute pancreatitis, 43.4 +- 22.3 in patients with diabetes mellitus, 20.4 +- 23.4 in patients with pancreatic cancer) than the mean functional rate in cases without pancreatic disease (86.4 +- 14.2). It is suggested that functional image of the pancreas reflecting pancreatic exocrine function and functional rate is a useful indicator of pancreatic exocrine function.

Use of the Electronic Medical Record to Assess Pancreas Size in Type 1 Diabetes

Science.gov (United States)

Virostko, John; Hilmes, Melissa; Eitel, Kelsey; Moore, Daniel J.; Powers, Alvin C.

2016-01-01

Aims This study harnessed the electronic medical record to assess pancreas volume in patients with type 1 diabetes (T1D) and matched controls to determine whether pancreas volume is altered in T1D and identify covariates that influence pancreas volume. Methods This study included 25 patients with T1D and 25 age-, sex-, and weight-matched controls from the Vanderbilt University Medical Center enterprise data warehouse. Measurements of pancreas volume were made from medical imaging studies using magnetic resonance imaging (MRI) or computed tomography (CT). Results Patients with T1D had a pancreas volume 47% smaller than matched controls (41.16 ml vs. 77.77 ml, P pancreas volume normalized by subject body weight, body mass index, or body surface area (all P pancreas volume over time (~ 6% of volume/year), whereas five controls scanned a year apart did not exhibit a decline in pancreas size (P = 0.03). The pancreas was uniformly smaller on the right and left side of the abdomen. Conclusions Pancreas volume declines with disease duration in patients with T1D, suggesting a protracted pathological process that may include the exocrine pancreas. PMID:27391588

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Power of Your Pancreas: Keep Your Digestive Juices Flowing

Science.gov (United States)

... 2017 Print this issue The Power of Your Pancreas Keep Your Digestive Juices Flowing En español Send ... in Check Better Check Your Bowels Wise Choices Pancreas Problems? Talk to your doctor if you have ...

Multi-atlas pancreas segmentation: Atlas selection based on vessel structure.

Science.gov (United States)

Karasawa, Ken'ichi; Oda, Masahiro; Kitasaka, Takayuki; Misawa, Kazunari; Fujiwara, Michitaka; Chu, Chengwen; Zheng, Guoyan; Rueckert, Daniel; Mori, Kensaku

2017-07-01

Automated organ segmentation from medical images is an indispensable component for clinical applications such as computer-aided diagnosis (CAD) and computer-assisted surgery (CAS). We utilize a multi-atlas segmentation scheme, which has recently been used in different approaches in the literature to achieve more accurate and robust segmentation of anatomical structures in computed tomography (CT) volume data. Among abdominal organs, the pancreas has large inter-patient variability in its position, size and shape. Moreover, the CT intensity of the pancreas closely resembles adjacent tissues, rendering its segmentation a challenging task. Due to this, conventional intensity-based atlas selection for pancreas segmentation often fails to select atlases that are similar in pancreas position and shape to those of the unlabeled target volume. In this paper, we propose a new atlas selection strategy based on vessel structure around the pancreatic tissue and demonstrate its application to a multi-atlas pancreas segmentation. Our method utilizes vessel structure around the pancreas to select atlases with high pancreatic resemblance to the unlabeled volume. Also, we investigate two types of applications of the vessel structure information to the atlas selection. Our segmentations were evaluated on 150 abdominal contrast-enhanced CT volumes. The experimental results showed that our approach can segment the pancreas with an average Jaccard index of 66.3% and an average Dice overlap coefficient of 78.5%. Copyright © 2017 Elsevier B.V. All rights reserved.

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File list: Pol.Emb.05.AllAg.Embryonic_pancreas [Chip-atlas[Archive

Lifescience Database Archive (English)

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Studies on the computed tomography of the pancreas in patients of liver cirrhosis

International Nuclear Information System (INIS)

Katsumata, Kazuo; Katsumata, Yoshinao; Nakagawa, Takeo; Ichihashi, Hidehito; Sakuma, Sadayuki.

1985-01-01

Computed tomography (CT) of the pancreas shows specific images in cases of pancreatitis or malignant tumors. However, precise analysis of CT images of the pancreas in other diseases or in normal individuals has not been made. After an extensive study on the pancreatic CT images of patients without liver cirrhosis, gall stones, diabetes mellitus, malignant tumors or pancreatitis, we reported that CT images of the outer margin or of the content of the pancreas can be divided into three types: smooth, fine-granule, and rough-granule. Since the CT values of the area surrounding rough granules were the same as those of fat, we concluded that the rough-granule type pancreas was rich in fat. We also reported that the incidence of the pancreas having rough-granule type content was low in lean individuals and high in obese ones. In the present study, CT images of the pancreas in patients with liver cirrhosis were analysed according to our classification with special references to clinical features; the following results were obtained: 1) The incidence of the pancreas having a rough-granule type margin was higher than that in the control patients (p<0.05). 2) No significant differences were observed in the incidence of rough-granule type pancreas between lean patients and obese ones. 3) In the patients with rough-granule type pancreas, the blood glucose levels two hours after meal were higher than those in the patients with the other types of pancreas. 4) The incidence of rough-granule type pancreas in patients of liver cirrhosis with ascites was significantly lower than that of the rough-granule type pancreas in patients without ascites. (author)

Has the gap between pancreas and islet transplantation closed?

Science.gov (United States)

Niclauss, Nadja; Morel, Philippe; Berney, Thierry

2014-09-27

Both pancreas and islet transplantations are therapeutic options for complicated type 1 diabetes. Until recent years, outcomes of islet transplantation have been significantly inferior to those of whole pancreas. Islet transplantation is primarily performed alone in patients with severe hypoglycemia, and recent registry reports have suggested that results of islet transplantation alone in this indication may be about to match those of pancreas transplant alone in insulin independence. Figures of 50% insulin independence at 5 years for either procedure have been cited. In this article, we address the question whether islet transplantation has indeed bridged the gap with whole pancreas. Looking at the evidence to answer this question, we propose that although pancreas may still be more efficient in taking recipients off insulin than islets, there are in fact numerous "gaps" separating both procedures that must be taken into the equation. These "gaps" relate to organ utilization, organ allocation, indication for transplantation, and morbidity. In-depth analysis reveals that islet transplantation, in fact, has an edge on whole pancreas in some of these aspects. Accordingly, attempts should be made to bridge these gaps from both sides to achieve the same level of success with either procedure. More realistically, it is likely that some of these gaps will remain and that both procedures will coexist and complement each other, to ensure that β cell replacement can be successfully implemented in the greatest possible number of patients with type 1 diabetes.

A Review of Safety and Design Requirements of the Artificial Pancreas.

Science.gov (United States)

Blauw, Helga; Keith-Hynes, Patrick; Koops, Robin; DeVries, J Hans

2016-11-01

As clinical studies with artificial pancreas systems for automated blood glucose control in patients with type 1 diabetes move to unsupervised real-life settings, product development will be a focus of companies over the coming years. Directions or requirements regarding safety in the design of an artificial pancreas are, however, lacking. This review aims to provide an overview and discussion of safety and design requirements of the artificial pancreas. We performed a structured literature search based on three search components-type 1 diabetes, artificial pancreas, and safety or design-and extended the discussion with our own experiences in developing artificial pancreas systems. The main hazards of the artificial pancreas are over- and under-dosing of insulin and, in case of a bi-hormonal system, of glucagon or other hormones. For each component of an artificial pancreas and for the complete system we identified safety issues related to these hazards and proposed control measures. Prerequisites that enable the control algorithms to provide safe closed-loop control are accurate and reliable input of glucose values, assured hormone delivery and an efficient user interface. In addition, the system configuration has important implications for safety, as close cooperation and data exchange between the different components is essential.

Clinical significance of circumportal pancreas, a rare congenital anomaly, in pancreatectomy.

Science.gov (United States)

Ohtsuka, Takao; Mori, Yasuhisa; Ishigami, Kousei; Fujimoto, Takaaki; Miyasaka, Yoshihiro; Nakata, Kohei; Ohuchida, Kenoki; Nagai, Eishi; Oda, Yoshinao; Shimizu, Shuji; Nakamura, Masafumi

2017-08-01

Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy. The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The prevalence of circumportal pancreas and related anatomical variations were assessed. Surgical procedures and postoperative outcomes were compared in patients with and without circumportal pancreas. Circumportal pancreas was observed in 9 of the 508 patients (1.7%). In all nine patients, the portal vein was completely encircled by the pancreatic parenchyma above the level of the splenoportal junction, and the main pancreatic duct ran dorsal to the portal vein. The rate of variant hepatic artery did not differ significantly in patients with and without circumportal pancreas. Pancreatic fistula developed more frequently in patients with than without circumportal pancreas (44% vs. 14%, p = 0.03), but other clinical parameters did not differ significantly in these two groups. Despite being rare, circumportal pancreas may increase the risk of postoperative pancreatic fistula in patients undergoing pancreatectomy. However, a prospective, large-cohort study is necessary to determine the real incidence of relevant anatomical variations and the definitive clinical significance of this rare anomaly. Copyright © 2016 Elsevier Inc. All rights reserved.

Ghrelin in the fetal pancreas - a digital quantitation study

DEFF Research Database (Denmark)

Hasselby, Jane Preuss; Maroun, Lisa Leth; Federspiel, Birgitte Hartnack

2012-01-01

Hasselby JP, Maroun LL, Federspiel BH, Vainer B. Ghrelin in the fetal pancreas - a digital quantitation study. APMIS 2011. Ghrelin is a hormone produced by specialized neuroendocrine cells located in the fetal pancreas. In the adult, ghrelin has multiple effects, but in the fetus the role...... of ghrelin and the distribution of ghrelin-producing cells is not well documented. The aim of this study was to describe and quantitate the number of ghrelin positive cells in the pancreas during gestation. The material consisted of pancreatic tissue from 19 fetuses at different gestational ages...

"Ductal adenocarcinoma in anular pancreas".

Science.gov (United States)

Benassai, Giacomo; Perrotta, Stefano; Furino, Ermenegildo; De Werra, Carlo; Aloia, Sergio; Del Giudice, Roberto; Amato, Bruno; Vigliotti, Gabriele; Limite, Gennaro; Quarto, Gennaro

2015-09-01

The annular pancreas is a congenital anomaly in which pancreatic tissue partially or completely surrounds the second portion of the duodenum. Its often located above of papilla of Vater (85%), rarely below (15%). This pancreatic tissue is often easily dissociable to the duodenum but there is same cases where it the tissue is into the muscolaris wall of the duodenum. We describe three case of annular pancreas hospitalized in our facility between January 2004 and January 2009. There were 2 male 65 and 69 years old respectively and 1 female of 60 years old, presented complaining of repeated episodes of mild epigastric pain. Laboratory tests (including tumor markers), a direct abdomen X-ray with enema, EGDS and total body CT scan were performed to study to better define the diagnosis. EUS showed the presence of tissue infiltrating the muscle layer all around the first part of duodenum. Biopsies performed found the presence of pancreatic tissue with focal areas of adenocarcinoma. Subtotal gastrectomy with Roux was performed. The histological examinations shows an annular pancreas of D1 with multiple focal area of adenocarcinoma. (T1aN0M0). We performed a follow up at 5 years. One patients died after 36 months for cardiovascular hit. Two patients, one male and one female, was 5-years disease-free. Annular pancreas is an uncommon congenital anomaly which usually presents itself in infants and newborn. Rarely it can present in late adult life with wide range of clinical severities thereby making its diagnosis difficult. Pre-operative diagnosis is often difficult. CT scan can illustrate the pancreatic tissue encircling the duodenum. ERCP and MRCP are useful in outlining the annular pancreatic duct. Surgery still remains necessary to confirm diagnosis and bypassing the obstructed segment. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Porphyrin lipid nanoparticles for enhanced photothermal therapy in a patient-derived orthotopic pancreas xenograft cancer model

Science.gov (United States)

MacLaughlin, Christina M.; Ding, Lili; Jin, Cheng; Cao, Pingjiang; Siddiqui, Iram; Hwang, David M.; Chen, Juan; Wilson, Brian C.; Zheng, Gang; Hedley, David W.

2016-03-01

Local disease control is a major problem in the treatment of pancreatic cancer, because curative-intent surgery is only possible in a minority of patients, and radiotherapy cannot be delivered in curative doses. Despite the promise of photothermal therapy (PTT) for ablation of pancreatic tumors, this approach remains under investigated. Using photothermal sensitizers in combination with laser light for PTT can result in more efficient conversion of light energy to heat, and confinement of thermal destruction to the tumor, thus sparing adjacent organs and vasculature. Porphyrins have been previously employed as photosensitizers for PDT and PTT, however their incorporation in to "porphysomes", lipid-based nanoparticles each containing ~80,000 porphyrins through conjugation of pyropheophorbide to phospholipids, carries two distinct advantages: 1) high-density porphyrin packing imparts the nanoparticles with enhanced photonic properties for imaging and phototherapy; 2) the enhanced permeability and retention effect may be exploited for optimal delivery of porphysomes to the tumor region thus high payload porphyrin delivery. The feasibility of porphysome-enhanced PTT for pancreatic cancer treatment was investigated using a patient-derived orthotopic pancreas xenograft tumor model. Uptake of porphysomes at the orthotopic tumor site was validated using ex vivo fluorescence imaging of intact organs of interest. The accumulation of porphysomes in orthotopic tumor microstructure was also confirmed by fluorescence imaging of excised tissue slices. PTT progress was monitored as changes in tumor surface temperature using IR optical imaging. Histological analyses were conducted to examine microstructure changes in tissue morphology, and the viability of remaining tumor tissues following exposure to heat. These studies may also provide insight as to the contribution of heat sink in application of thermal therapies to highly vascularized pancreatic tumors.

Prox1-Heterozygosis Sensitizes the Pancreas to Oncogenic Kras-Induced Neoplastic Transformation

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Yiannis Drosos

2016-03-01

Full Text Available The current paradigm of pancreatic neoplastic transformation proposes an initial step whereby acinar cells convert into acinar-to-ductal metaplasias, followed by progression of these lesions into neoplasias under sustained oncogenic activity and inflammation. Understanding the molecular mechanisms driving these processes is crucial to the early diagnostic and prevention of pancreatic cancer. Emerging evidence indicates that transcription factors that control exocrine pancreatic development could have either, protective or facilitating roles in the formation of preneoplasias and neoplasias in the pancreas. We previously identified that the homeodomain transcription factor Prox1 is a novel regulator of mouse exocrine pancreas development. Here we investigated whether Prox1 function participates in early neoplastic transformation using in vivo, in vitro and in silico approaches. We found that Prox1 expression is transiently re-activated in acinar cells undergoing dedifferentiation and acinar-to-ductal metaplastic conversion. In contrast, Prox1 expression is largely absent in neoplasias and tumors in the pancreas of mice and humans. We also uncovered that Prox1-heterozygosis markedly increases the formation of acinar-to-ductal-metaplasias and early neoplasias, and enhances features associated with inflammation, in mouse pancreatic tissues expressing oncogenic Kras. Furthermore, we discovered that Prox1-heterozygosis increases tissue damage and delays recovery from inflammation in pancreata of mice injected with caerulein. These results are the first demonstration that Prox1 activity protects pancreatic cells from acute tissue damage and early neoplastic transformation. Additional data in our study indicate that this novel role of Prox1 involves suppression of pathways associated with inflammatory responses and cell invasiveness.

Stimulus-secretion coupling in the developing exocrine pancreas

International Nuclear Information System (INIS)

Chang, A.Y.S.

1986-01-01

Acinar cells of the embryonic pancreas are filled with zymogen granules containing, among others, the secretory protein, cholecystokinin (CCK) α-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 125 I-CCK octapeptide specifically bound/cell equivalent or a change in the affinity of binding. Light microscopic autoradiography revealed a similar 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 ++ concentration, [Ca ++ ]c, in the embryonic pancreas, 45 Ca ++ efflux from tracer-loaded lobules was measured. Efflux of 45 Ca ++ from both embryonic and neonatal pancreas was comparably increased in the presence of CCK

CT findings of pancreas lipomatosis and associated diseases

International Nuclear Information System (INIS)

Baek, Seung Yon; Lee, Seung Chul; Kim, Mi Young; Lee, Moon Gyu; Cho, Kyoung Sik; Auh, Yong Ho

1992-01-01

Pancreas lipomatosis is defined as fatty replacement of pancreatic acinar cells. Of the nine cases evaluated, seven cases (77.8%) of lipomations were limited in body and tail, one case (11.1%) showed total lipomatosis, excluding uncinate process and the remaining one case (11.1%) only in tail. As to the severity of lipomatosis, complete fat replacement in body and tail was found in four cases (44.4%), incomplete body and complete tail involvement in two (22.2%), incomplete body and tail, complete all except uncinate process, and complete tail involvements were found in one case (11.1%) each. Associated or predisposing factors included three diabetes mellitus(33.3%) combined with pancreas divisum, pancreas lithiasis and cholelithiasis respectively, hepatitis (22.2%) in two, and pseudocyst (11.1%) in one case, but in three cases (33.3%) nothing was found. In conclusion, pancreas lipomations was easily diagnosed by the abdominal CT and it was associated or predisposed by several entities but had no major clinical symptoms, such as pancreatic insufficiency

Gastrin-releasing peptide in the porcine pancreas

DEFF Research Database (Denmark)

Holst, J J; Poulsen, Steen Seier

1987-01-01

to consist of one main form, namely the 27-amino acid peptide originally extracted from porcine stomach, and small amounts of a C-terminal fragment identical with the C-terminal 10-amino acid peptide. Gastrin-releasing peptide-like immunoreactivity released from the isolated perfused porcine pancreas during...... electrical vagal stimulation was shown by gel filtration to consist of the same two forms. By use of immunocytochemical techniques employing an antiserum directed against its N terminus, GRP was localized to varicose nerve fibers in close association with the exocrine tissue of the porcine pancreas...... in particular. Some fibers were found penetrating into pancreatic islets also. Immunoreactive nerve cell bodies as well as fibers were found within intrapancreatic ganglia. The potency of GRP in stimulating exocrine as well as endocrine secretion from the porcine pancreas, its presence in close contact...

European Union pediatric legislation jeopardizes worldwide, timely future advances in the care of children with cancer.

Science.gov (United States)

Rose, Klaus

2014-02-01

Diagnosis of childhood cancer is no longer an automatic death sentence, but it has not lost all of its horror. Drugs, surgery, radiation, and clinical trials have advanced our capacity to handle these cancers, but pediatric cancers still face challenges. Pediatric pharmaceutical legislation was introduced in the United States in 1997 and has triggered many clinical trials that have helped us better understand what drugs do to a child's body and vice versa. Following the US precedence, the European Union introduced its own legislation. The US legislation was designed to generate additional pediatric data and balances between mandatory requirements and voluntary incentives. The US legislation was designed to mandate full registration of all new drugs for children whenever there is any potential pediatric use. The purpose of this article is to discuss unintended negative consequences of the legislation of the European Medicines Agency (EMA). We analyzed the effects of the EU pediatric legislation with respect to the history of the emergence of modern drugs, pediatric clinical pharmacology, and the development of drugs for pediatric malignancies. No new drug can be registered in the European Union without a detailed pediatric investigation plan (PIP) approved by the EMA's Pediatric Committee (PDCO). This has moved the discussion of the pediatric aspects of drug development to an earlier stage and has increased public awareness. It also has brought industry and pediatric oncologists closer together. However, in a review of >100 PDCO PIP decisions in childhood cancer, we found a lack of balance between the legitimate desire to include children in drug development and the common sense needed in the complex worlds of drug development and pediatric oncology. Many decisions appeared to have been based on both exaggerated assumptions about the frequency of childhood malignancies and the feasibility of the clinical trials proposed. Pharmaceutical companies are being forced

Computed tomography of pancreas in diabetic patients in relation to diabetic retinopathy

International Nuclear Information System (INIS)

Katsumata, K.; Katsumata, Y.; Sakuma, S.; Kaii, O.; Shimamoto, K.; Hirabayashi, N.; Nakagawa, T.

1987-01-01

Lipomatous pancreas is hardly diagnosed in living humans and usually recognized at autopsy. In the present work, it is proposed that lipomatous pancreas can be diagnosed in living humans by computed tomography (CT) of the pancreas. 2 refs.; 1 figure

Current radiotherapeutic approaches to pancreatic cancer

International Nuclear Information System (INIS)

Dobelbower, R.R. Jr.

1981-01-01

Adenocarcinoma of the pancreas is not a radioresistant neoplasm, as was once believed. The data now suggest that in some instances this cancer may be radiocurable. This fact seems to justify the risk of pancreatic biopsy even in the face of unresectable disease, for it is well known that many benign conditions imitate pancreatic cancer. Clinical benefit from radiation for pancreatic cancer treatment is dose related. Careful delineation of tumor margins, precision treatment planning, and precision dose delivery can minimize damage to adjacent normal tissues. Interstitial implantation and intraoperative electron beam therapy are being studied as methods of accurate dose delivery for pancreatic cancer. Fractionation studies and high LET studies are in embryonic stages. Combined modality regimens may have much to offer in terms of improved palliation and survival for patients with localized adenocarcinoma of the pancreas

Tumor aggressiveness and patient outcome in cancer of the pancreas assessed by dynamic 18F-FDG PET/CT.

Science.gov (United States)

Epelbaum, Ron; Frenkel, Alex; Haddad, Riad; Sikorski, Natalia; Strauss, Ludwig G; Israel, Ora; Dimitrakopoulou-Strauss, Antonia

2013-01-01

This study aimed to assess the role of a quantitative dynamic PET model in pancreatic cancer as a potential index of tumor aggressiveness and predictor of survival. Seventy-one patients with (18)F-FDG-avid adenocarcinoma of the pancreas before treatment were recruited, including 27 with localized tumors (11 underwent pancreatectomy, and 16 had localized nonresectable tumors) and 44 with metastatic disease. Dynamic (18)F-FDG PET images were acquired over a 60-min period, followed by a whole-body PET/CT study. Quantitative data measurements were based on a 2-compartment model, and the following variables were calculated: VB (fractional blood volume in target area), K(1) and k(2) (kinetic membrane transport parameters), k(3) and k(4) (intracellular (18)F-FDG phosphorylation and dephosphorylation parameters, respectively), and (18)F-FDG INF (global (18)F-FDG influx). The single significant variable for overall survival (OS) in patients with localized disease was (18)F-FDG INF. Patients with a high (18)F-FDG INF (>0.033 min(-1)) had a median OS of 6 and 5 mo for nonresectable and resected tumors, respectively, versus 15 and 19 mo for a low (18)F-FDG INF in nonresectable and resected tumors, respectively (P measured by dynamic PET in newly diagnosed pancreatic cancer correlated with the aggressiveness of disease. The (18)F-FDG INF was the single most significant variable for OS in patients with localized disease, whether resectable or not.

Antimicrobial Peptide Human Neutrophil Peptide 1 as a Potential Link Between Chronic Inflammation and Ductal Adenocarcinoma of the Pancreas.

Science.gov (United States)

Pausch, Thomas; Adolph, Sarah; Felix, Klaus; Bauer, Andrea S; Bergmann, Frank; Werner, Jens; Hartwig, Werner

Defensins are antimicrobial peptides playing a role in innate immunity, in epithelial cell regeneration, and in carcinogenesis of inflammation-triggered malignancies. We analyzed this role in pancreatic ductal adenocarcinoma (PDAC) in the context of its association with chronic pancreatitis (CP). Human tissue of healthy pancreas, CP, and PDAC was screened for defensins by immunohistochemistry. Defensin α 1 (human neutrophil peptide 1 [HNP-1]) expression was validated using mass spectrometry and microarray analysis. Human neutrophil peptide 1 expression and influences of proinflammatory cytokines (tumor necrosis factor α, interleukin 1β, and interferon γ) were studied in human pancreatic cancer cells (Colo 357, T3M4, PANC-1) and normal human pancreatic duct epithelial cells (HPDE). Accumulation of HNP-1 in malignant pancreatic ductal epithelia was seen. Spectrometry showed increased expression of HNP-1 in CP and even more in PDAC. At RNA level, no significant regulation was found. In cancer cells, HNP-1 expression was significantly higher than in HPDE. Proinflammatory cytokines significantly led to increased HNP-1 levels in culture supernatants and decreased levels in lysates of cancer cells. In HPDE cytokines significantly decreased HNP-1 levels. Inflammatory regulation of HNP-1 in PDAC tissue and cells indicates that HNP-1 may be a link between chronic inflammation and malignant transformation in the pancreas.

Trade Union Channels for Influencing European Union Policies

Directory of Open Access Journals (Sweden)

Bengt Larsson

2015-10-01

Full Text Available This paper analyzes what channels trade unions in Europe use when trying to influence European Union (EU policies. It compares and contrasts trade unions in different industrial relations regimes with regard to the degree to which they cooperate with different actors to influence EU policies, while also touching on the importance of sector differences and organizational resources. The study is based on survey data collected in 2010–2011 from unions affiliated with the European Trade Union Confederation and from below peak unions in 14 European countries. Results of the survey show that the ‘national route’ is generally the most important for trade unions in influencing EU policies in the sense that this channel is, on average, used to the highest degree. In addition, the survey delineates some important differences between trade unions in different industrial relations regimes with regard to the balance between the national route and different access points in the ‘Brussels route’.

Results of diagnosis of pancreatic cancer by computed tomography (CT)

International Nuclear Information System (INIS)

Kimura, Kazue; Okuaki, Koji; Ito, Masami; Katakura, Toshihiko; Suzuki, Kenji

1981-01-01

Results of examination of pancreatic diseases, especially pancreatic cancer, conducted by CT during the past 3 years are summarized. The EMI CT Type 5000 or 5005 were used. During the 3 years from September 1976 to August 1979, a total of 1961 patients were examined by CT, and the upper abdomen was examined in 772 of these patients. In 97 patients, positive findings were obtained in the CT image of the pancreas. In 52 of these patients, the findings were confirmed operatively or by autopsy. Though cancer of the pancreas was diagnosed by CT in 30 patients, it was confirmed in 20 by surgical operation and in 1 by autopsy. Of the 9 misdiagnosed cases, 4 were cases of infiltration of the pancreas by carcinoma of the stomach or bile duct, and the other 5 were one case each of lipoma of the abdominal wall, normal pancreas, hyperplasia of Langerhans's islets of the pancreas tail, abscess between the pancreas and the posterior wall of the stomach, and choledocholithiasis. A case diagnosed by CT as cholelithiasis was a carcinoma measuring 5 x 5 x 6 cm located on the head of the pancreas, complicated by choledocholithiasis. The 22 patients with carcinoma of the pancreas were 9 with lesions less than 3.5 x 3.0 x 3.0 cm in size who could be radically operated, 6 who underwent exploratory laparotomy or autopsy, and 7 in whom operation was impossible. False negative and false positive CT results are also discussed. (author)

Computerized tomography of the pancreas

International Nuclear Information System (INIS)

Dondelinger, R.; Campos, R.O.; Lamarque, J.L.

1979-01-01

Pancreatic anatomy is briefly reviewed. Tomographic images from normal pancreas and from pathological states (different kinds of pancreatitis; pancreatic tumors) of this organ are discussed. (M.A.) [pt

Radioisotope Scanning of the Pancreas with Selenomethionine-Se{sup 75}; Gammagraphie du Pancreas a l'Aide de la Selenomethionine-{sup 75}Se; Diagnosticheskoe fotoskennirovanie podzheludochnoj zhelezy; Gammagrafia del Pancreas Mediante Radioisotopos

Energy Technology Data Exchange (ETDEWEB)

Sodee, D. B. [Doctors Hospital and Renner Clinic Foundation, Cleveland Heights, OH (United States)

1964-10-15

Photoscanning of the pancreas utilizing selenomethionine- Se{sup 75} has recently been shown to be a practical technique. In a series of 100 patients who underwent 250 such photoscans, the pancreas was visualized in 90% of the cases. The physiological stimulation of the pancreas was found to be the most important factor in pancreatic selenomethionine-Se{sup 75} concentration. Utilizing a 30-g protein meal, physiological stimulation of the pancreas was begun one hour before the intravenous administration of 3 to 4- {mu}c/kg selenomethionine-Se{sup 75}. Fifteen minutes later continued stimulation of the pancreas was ensured by the oral administration of 900 {mu}g of glutamic acid hydrochloride. Before scanning the pancreas, a 3/8 - in curved lead shield was placed over the liver bed previously outlined by an Au{sup 198} liver scan. This lead shield blocks the radiation from the concentration of selenomethionine-Se{sup 75} in the liver that in the past impaired accurate delineation of the pancreas. The authors have recently utilized a 5-in by 3-in crystal and a 121-hole lead collimator with a 5-in focal distance. This has further improved delineation of the pancreas and, as the technique is perfected, smaller lesions at greater depths may be visualized. The results show that pancreatic carcinoma does not concentrate selenomethionine-Se{sup 75} as well as normal tissue. Five of six patients with pancreatic carcinoma had their disease correctly interpreted by this procedure. The smallest carcinoma not visualized was obscured by an enlarged liver. Acute and chronic pancreatitis are also confirmed by the pancreatic scan as the impaired cells of the pancreas do not concentrate selenomethionine-Se{sup 75}. The author also reports selective uptake of selenomethionine-Se{sup 75} by parathyroid tissue. Utilizing the. same scanning technique parathyroid adenomas in a small group of hyperparathyroid patients have been visualized. Photoscanning of the pancreas is already a

MR imaging evaluation of pancreas and hepatobiliary system in cystic fibrosis

International Nuclear Information System (INIS)

Murayama, S.; Robinson, A.E.; Stallworth, J.; Mulvihill, D.; Beckerman, R.; Davis, S.

1988-01-01

The pancreas and hepatobiliary system of 20 patients with cystic fibrosis were analyzed with a 1.5-T magnet. T1-weighted, T2-weighted, and proton-density images were obtained, and the T1 and T2 values of the pancreas were calculated. Signal intensity ratios were calculated for the signal intensities of the pancreas and the liver relative to that of muscle and fat on each pulse sequence. Fatty replacement of the pancreas and regenerating nodules of biliary cirrhosis were readily identified on T1-weighted images. The T1 values for pancreatic tissue showed promise as a good marker for pancreatic disease progression. Pancreas-to-fat signal intensity ratios on 300/20 (repetition time msec/echo time msec) and 2,000/75 images were considered to be a good standard for evaluating the level of pancreatic involvement

Pancreas-sparing duodenectomy for an obstructive adenocarcinoma of the duodenum

OpenAIRE

Lam, D; Croome, KP; Hernandez-Alejandro, R

2012-01-01

A duodenal adenocarcinoma arising from the junction of the second and third portion of the duodenum, which was resected by pancreas-sparing duodenectomy, is reported. The completely obstructing tumour was circumferential and measured 6.5cm x 3.5cm x 1.0 cm. There was no evidence of pancreas invasion, nor any lymph node metastasis. Pancreas-sparing duodenectomy was performed, with dissection of the pancreaticoduodenal lymph nodes. The proximal duodenum was transected just distal to the ampula ...

Squamous-lined cyst of the pancreas: Radiological–pathological correlation

International Nuclear Information System (INIS)

Kubo, T.; Takeshita, T.; Shimono, T.; Hashimoto, S.; Miki, Y.

2014-01-01

Pancreatic cystic lesions are increasingly being detected incidentally because of the increased use of cross-sectional imaging. Squamous-lined cysts of the pancreas (lymphoepithelial cyst, epidermoid cyst, and dermoid cyst) are rare cystic lesions lined with squamous epithelium. Distinguishing squamous-lined cysts from other cystic lesions of the pancreas is important to avoid unnecessary surgery, because squamous-lined cysts of the pancreas have no malignant potential. The purpose of this review is to describe findings on computed tomography and magnetic resonance imaging and the histopathological characteristics of squamous-lined cysts, and to summarize the key points of differential diagnosis for pancreatic cystic lesions

Pancreatic cancer

International Nuclear Information System (INIS)

Diamond, D.; Fisher, B.

1975-01-01

Diagnostic and therapeutic advances of the last 30 years have left unchanged the course and prognosis of carcinoma of the exocrine pancreas. The most important reasons for this are the anatomic location and biologic nature of the tumor. An additional factor of importance is the consistently reported 4 to 9 month delay in diagnosis, also unchanged in 30 years. Recent controversy has developed concerning the mainstay of our current surgical treatment surgical treatment, the Whipple pancreaticoduodenectomy and its modifications, and its role as the most efficacious surgical approach to this disease. It is the purpose of this paper to review and summarize the clinical characteristics of carcinoma of the exocrine pancreas and to review and reassess the standard operative approach. Cancer of the head, body, and tail of the pancreas will be considered together because they have many features in common

Proteomic analysis of pancreas derived from adult cloned pig

International Nuclear Information System (INIS)

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

2008-01-01

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

Neuroendocrine tumors of the pancreas

International Nuclear Information System (INIS)

Holzapfel, Konstantin; Rummeny, Ernst J.; Gaertner, Florian C.

2011-01-01

Neuroendocrine tumors (NET) of the pancreas are rare entities. Functioning tumors tend to present early with specific symptoms and typical abnormalities in laboratory values. In contrast, non-functioning NET are often diagnosed with delay and become evident by tumor-related symptoms like pain, weight-loss or jaundice. The role of imaging is to localize and delineate the primary tumor and to detect metastases. In the diagnosis of NET radiologic techniques like computed tomography (CT) and magnetic resonance imaging (MRI) are applied. In certain cases nuclear medicine techniques like somatostatin receptor scintigraphy (SRS) and positron emission tomography (PET) using radioactively labelled somatostatin analogues are used. The present article reviews characteristic imaging findings of both functioning and non-functioning NET of the pancreas. (orig.)

Retinoid Signaling in Pancreatic Cancer, Injury and Regeneration

Science.gov (United States)

Colvin, Emily K.; Susanto, Johana M.; Kench, James G.; Ong, Vivienna N.; Mawson, Amanda; Pinese, Mark; Chang, David K.; Rooman, Ilse; O'Toole, Sandra A.; Segara, Davendra; Musgrove, Elizabeth A.; Sutherland, Robert L.; Apte, Minoti V.; Scarlett, Christopher J.; Biankin, Andrew V.

2011-01-01

Background Activation of embryonic signaling pathways quiescent in the adult pancreas is a feature of pancreatic cancer (PC). These discoveries have led to the development of novel inhibitors of pathways such as Notch and Hedgehog signaling that are currently in early phase clinical trials in the treatment of several cancer types. Retinoid signaling is also essential for pancreatic development, and retinoid therapy is used successfully in other malignancies such as leukemia, but little is known concerning retinoid signaling in PC. Methodology/Principal Findings We investigated the role of retinoid signaling in vitro and in vivo in normal pancreas, pancreatic injury, regeneration and cancer. Retinoid signaling is active in occasional cells in the adult pancreas but is markedly augmented throughout the parenchyma during injury and regeneration. Both chemically induced and genetically engineered mouse models of PC exhibit a lack of retinoid signaling activity compared to normal pancreas. As a consequence, we investigated Cellular Retinoid Binding Protein 1 (CRBP1), a key regulator of retinoid signaling known to play a role in breast cancer development, as a potential therapeutic target. Loss, or significant downregulation of CRBP1 was present in 70% of human PC, and was evident in the very earliest precursor lesions (PanIN-1A). However, in vitro gain and loss of function studies and CRBP1 knockout mice suggested that loss of CRBP1 expression alone was not sufficient to induce carcinogenesis or to alter PC sensitivity to retinoid based therapies. Conclusions/Significance In conclusion, retinoid signalling appears to play a role in pancreatic regeneration and carcinogenesis, but unlike breast cancer, it is not mediated directly by CRBP1. PMID:22220202

Retinoid signaling in pancreatic cancer, injury and regeneration.

Directory of Open Access Journals (Sweden)

Emily K Colvin

Full Text Available BACKGROUND: Activation of embryonic signaling pathways quiescent in the adult pancreas is a feature of pancreatic cancer (PC. These discoveries have led to the development of novel inhibitors of pathways such as Notch and Hedgehog signaling that are currently in early phase clinical trials in the treatment of several cancer types. Retinoid signaling is also essential for pancreatic development, and retinoid therapy is used successfully in other malignancies such as leukemia, but little is known concerning retinoid signaling in PC. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the role of retinoid signaling in vitro and in vivo in normal pancreas, pancreatic injury, regeneration and cancer. Retinoid signaling is active in occasional cells in the adult pancreas but is markedly augmented throughout the parenchyma during injury and regeneration. Both chemically induced and genetically engineered mouse models of PC exhibit a lack of retinoid signaling activity compared to normal pancreas. As a consequence, we investigated Cellular Retinoid Binding Protein 1 (CRBP1, a key regulator of retinoid signaling known to play a role in breast cancer development, as a potential therapeutic target. Loss, or significant downregulation of CRBP1 was present in 70% of human PC, and was evident in the very earliest precursor lesions (PanIN-1A. However, in vitro gain and loss of function studies and CRBP1 knockout mice suggested that loss of CRBP1 expression alone was not sufficient to induce carcinogenesis or to alter PC sensitivity to retinoid based therapies. CONCLUSIONS/SIGNIFICANCE: In conclusion, retinoid signalling appears to play a role in pancreatic regeneration and carcinogenesis, but unlike breast cancer, it is not mediated directly by CRBP1.

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Huge mucinous cystadenoma of the pancreas mistaken for a ...

African Journals Online (AJOL)

Cystic tumors of the pancreas are rare and can be confused with pseudocysts.We present a 50 year old woman with a huge mucinous cystadenoma of the pancreas initially diagnosed and managed with a cystojejunostomy and cyst wall biopsy. She required another laparotomy and tumor excision after histological ...

Laparoscopic treatment of heterotopic pancreas in the prepyloric region

Directory of Open Access Journals (Sweden)

Galvez-Valdovinos R

2006-01-01

Full Text Available Heterotopic pancreas is a rare condition and its diagnosis is often difficult. Traditionally the condition is treated by open surgery. We report two young women with symptomatic heterotopic pancreas located in the prepyloric region. In the first patient, upper gastrointestinal endoscopy identified a round sessile lesion with a central umbilication of the mucosa without bleeding and in the second endoscopy showed a lesion with intraluminal protrusion. In both cases, a diagnostic laparoscopy identified masses amenable to laparoscopic excision. Intraoperative histology confirmed ectopic pancreatic tissue in both. In the treatment of heterotopic pancreas, laparoscopic excision provides a feasible, safe and effective treatment option.

Cystic tumors of the pancreas

International Nuclear Information System (INIS)

Brambs, H.J.; Juchems, M.

2008-01-01

Cystic lesions of the pancreas encompass a broad spectrum of benign, premalignant, and malignant tumors which are primarily cystic or result from cystic necroses of solid neoplasms. Because of the wide use of cross-sectional imaging techniques they are increasingly being identified in asymptomatic patients as well as in patients presenting with abdominal pain, jaundice or pancreatitis. Among these lesions, intraductal papillary mucinous neoplasms, serous cystic neoplasms and mucinous cystic neoplasms represent the majority of cases. With increasing experience with these tumors, a refinement of our understanding of their morphology and of their natural course has emerged. It is important to be familiar with the CT and MR imaging features of these lesions to differentiate these tumors and to orient the diagnosis towards benign or malignant forms. Because characterization of cystic tumors of the pancreas can sometimes be difficult due to overlapping imaging features, additional criteria such as clinical symptoms, localization, age and gender have to be taken into account. If appropriately treated, these tumors can usually be cured by resection and the decreasing risk of pancreatic surgery has led to an increasing number of resections of pancreatic tumors. The management of cystic tumors of the pancreas has not yet been standardized and the correct evaluation and subsequent management of the disease in asymptomatic patients have not been fully defined. (orig.) [de

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Ectopic pancreas causing partial gastric outlet obstruction: a case ...

African Journals Online (AJOL)

Ectopic pancreas causing partial gastric outlet obstruction: a case report and review of literature. ... Nigerian Journal of Surgery ... Gastric outlet obstruction resulting from ectopic pancreas in an adult is the first of its kind in our center; we, therefore, present this case to describe the challenges faced with diagnosis, treatment, ...

Ectopic Pancreas Causing Partial Gastric Outlet Obstruction: A Case ...

African Journals Online (AJOL)

Ectopic pancreas is a rare cause of gastric outlet obstruction, perhaps rarer still among Africans. Although the entity is known, the diagnostic challenges are enormous, especially in the poor‑resource environment. Gastric outlet obstruction resulting from ectopic pancreas in an adult is the first of its kind in our center;.

Quantitative evaluation in enhancement of pancreas and adjacent vessels during spiral CT

International Nuclear Information System (INIS)

Kim, Hyoung Seuk; Shin, Kue Hee; Park, Cheol Min; Cha, Sang Hoon; Chung, Kyoo Byung

1997-01-01

To determine by quantitative evaluation of pancreatic and adjacent vascular enhancement during spiral CT, the ideal scan delay for examination of the pancreas. Dual(n=3D90) and triple(n=3D90) phase spiral CT scans of patients whose pancreas showed no pathologic condition were retrospectively evaluated. Dual-phase scans were performed at 43 seconds(early), and 5-6 minutes(delayed) after the injection of 120ml of contrast material at an injection rate of 3ml/sec;triple-phase scans were performed at 25 seconds(arterial),60-65 seconds (portal) and 5-6 minutes (delayed) after the injection of 120-140ml of contrast material at an injection rate of 2-4ml/sec, and ten patients also underwent precontrast scanning. CT attenuation values(HU) were measured in the head, body and tail of the pancreas, aorta, and main portal vein during each phase of all scans. Triple-phase protocol was used to measure the effect of different total volumes and injection rates on enhancement of the pancreas and adjacent vessels. There was no significant difference in the degree of enhancement of the pancreas head, body and tail during each phase(p>0.05). The pancreas was maximally enhanced on 43 second delayed scan(132±20HU)(p 0.05). The main portal vein showed maximum enhancement on 43-second delayed scan(207±44HU)(p<0.05). Different total volume of contrast material did not change the enhancement of the pancreas and adjacent vessels. At an injection rate of 2ml/sec, peak enhancement of the pancreas, aorta and portal vein was obtained on 60-65 second delayed scan, and at 4ml/sec, peak enhancement was obtained on 25 second delayed scan(p<0.05). Observing the usual protocols for abdominal spiral CT scanning, the pancreas was most effectively evaluated using a 43-second delayed scan. An increased injection rate resulted in earlier enhancement of the pancreas, aorta and portal vein

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Nutritional links to plausible mechanisms underlying pancreatic cancer: a conference report.

Science.gov (United States)

Hine, R Jean; Srivastava, Sudhir; Milner, John A; Ross, Sharon A

2003-11-01

Adenocarcinoma of the pancreas is one of most catastrophic and least understood of cancers. Evidence from clinical studies indicates that the development of pancreas cancer progresses over many years before symptoms appear. Most people with pancreatic cancer die within six months of diagnosis. The lack of early disease markers, the paucity of direct subject/patient interview data and limited availability of high quality biological samples have slowed progress toward identifying environmental and genetic disease risk factors. Much remains to be learned about the development of pancreatic cancer and about potential interventions for disease prevention. Epidemiological and mechanistic studies examining risk factors for pancreatic cancer supply little consistent or strong evidence to provide a cohesive prevention strategy for this cancer, but offer clues for future research concerning the prevention and early detection of this devastating disease. This Executive Summary provides background discussion on pancreatic cancer and summaries of each of the topics discussed at the workshop, including 1) Molecular aspects, 2) Dietary and other risk factors for pancreatic cancer, 3) The metabolic hypothesis for pancreatic cancer, 4) Preclinical studies on pancreatic cancer, 5) Methylation, 6) Oxidative stress and 7) Biomarker Profiling. This document also contains a compilation of recommendations for future research, concluding remarks, a list of speakers and participants attending the workshop, and a selection of key references to aid future research into nutritional links to mechanisms underlying pancreas cancer. The recommendations section suggests gaps in current knowledge and articulates future directions for this area of investigation.

CT diagnosis of pancreatitis and carcinoma of the pancreas

International Nuclear Information System (INIS)

Sager, W.D.; Nedden, D. zur; Lepuschuetz, H.; Zalaudek, G.; Bodner, E.; Fotter, R.; Lammer, J.; Innsbruck Univ.; Graz Univ.; Innsbruck Univ.

1981-01-01

The article reports on 78 CT scans of surgically diseases of the pancreas, 30 cases of chronic pancreatitis, 12 cases of haemorrhagic-necrotizing pancreatitis, and 36 cases of carcinoma of the pancreas. 12 of these cases were operable, whereas 234 were inoperable. The operable carcinomas were so small that proper diagnosis was effected in 50% only, whereas the inoperable carcinomas eluded CT identification in 17% of the cases only. The most important signs of an operable carcinoma of the pancreas are a well-defined enlargement and inhomogeneity of the parenchyma with reduced contrast, especially on bolus injection, as well as dilatation of the bile duct system. The most essential criteria for inoperability are absence of boundaries, especially towards the dorsal side, with infiltration of the retroperitoneal fatty tissue, and lack of delineation of the large vessels. According to the present state of the art, CT does not supply definite criteria for differentiating between an operable carcinoma of the pancreas and chronic fibrotic pancreatitis. Overstepping of the marginal contours is a reliably distinctive feature between carcinoma and pancreatitis, but it also points to the inoperable nature of the disease. Haemorrhagic-necrotizing pancreatitis is characterized by definite CT criteria, so that diagnosis is easy. Computerised tomography is a valuable diagnostic tool in diseases of the pancreas and can supply conclusive pointers towards the operability of a tumor. (orig.) [de

Pancreas lineage allocation and specification are regulated by sphingosine-1-phosphate signalling

Science.gov (United States)

Serafimidis, Ioannis; Rodriguez-Aznar, Eva; Lesche, Mathias; Yoshioka, Kazuaki; Takuwa, Yoh; Dahl, Andreas; Pan, Duojia; Gavalas, Anthony

2017-01-01

During development, progenitor expansion, lineage allocation, and implementation of differentiation programs need to be tightly coordinated so that different cell types are generated in the correct numbers for appropriate tissue size and function. Pancreatic dysfunction results in some of the most debilitating and fatal diseases, including pancreatic cancer and diabetes. Several transcription factors regulating pancreas lineage specification have been identified, and Notch signalling has been implicated in lineage allocation, but it remains unclear how these processes are coordinated. Using a combination of genetic approaches, organotypic cultures of embryonic pancreata, and genomics, we found that sphingosine-1-phosphate (S1p), signalling through the G protein coupled receptor (GPCR) S1pr2, plays a key role in pancreas development linking lineage allocation and specification. S1pr2 signalling promotes progenitor survival as well as acinar and endocrine specification. S1pr2-mediated stabilisation of the yes-associated protein (YAP) is essential for endocrine specification, thus linking a regulator of progenitor growth with specification. YAP stabilisation and endocrine cell specification rely on Gαi subunits, revealing an unexpected specificity of selected GPCR intracellular signalling components. Finally, we found that S1pr2 signalling posttranscriptionally attenuates Notch signalling levels, thus regulating lineage allocation. Both S1pr2-mediated YAP stabilisation and Notch attenuation are necessary for the specification of the endocrine lineage. These findings identify S1p signalling as a novel key pathway coordinating cell survival, lineage allocation, and specification and linking these processes by regulating YAP levels and Notch signalling. Understanding lineage allocation and specification in the pancreas will shed light in the origins of pancreatic diseases and may suggest novel therapeutic approaches. PMID:28248965

Improvement of diagnostic accuracy, and clinical evaluation of computed tomography and ultrasonography for deep seated cancers

International Nuclear Information System (INIS)

Arimizu, Noboru

1980-01-01

Cancers of the liver, gallbladder, and pancreas which were difficult to be detected at an early stage were studied. Diagnostic accuracy of CT and ultrasonography for vesectable small cancers was investigated by the project team and coworkers. Only a few cases of hepatocellular carcinoma, cancer of the common bile duct, and cancer of the pancreas head, with the maximum diameter of 1 - 2 cm, were able to be diagnosed by CT. There seemed to be more false negative cases with small cancers of that size. The limit of the size which could be detected by CT was thought to be 2 - 3 cm. Similar results were obtained by ultrasonography. Cancer of the pancreas body with the maximum diameter of less than 3.5 cm could not be detected by both CT and ultrasonography. Diagnostic accuracy of CT for liver cancer was improved by selective intraarterial injection of contrast medium. Improvement of the quality of ultrasonograms was achieved through this study. Merits and demerits of CT and ultrasonography were also compared. (Tsunoda, M.)

Improvement of diagnostic accuracy, and clinical evaluation of computed tomography and ultrasonography for deep seated cancers

Energy Technology Data Exchange (ETDEWEB)

Arimizu, N [Chiba Univ. (Japan). School of Medicine

1980-06-01

Cancers of the liver, gallbladder, and pancreas which were difficult to be detected at an early stage were studied. Diagnostic accuracy of CT and ultrasonography for resectable small cancers was investigated by the project team and co-workers. Only a few cases of hepatocellular carcinoma, cancer of the common bile duct, and cancer of the pancreas head, with the maximum diameter of 1 - 2 cm, were able to be diagnosed by CT. There seemed to be more false negative cases with small cancers of that size. The limit of the size which could be detected by CT was thought to be 2 - 3 cm. Similar results were obtained by ultrasonography. Cancer of the pancreas body with the maximum diameter of less than 3.5 cm could not be detected by both CT and ultrasonography. Diagnostic accuracy of CT for liver cancer was improved by selective intraarterial injection of contrast medium. Improvement of the quality of ultrasonograms was achieved through this study. Merits and demerits of CT and ultrasonography were also compared.

File list: Oth.Oth.10.AllAg.Pancreas_and_brain [Chip-atlas[Archive

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File list: Unc.Oth.10.AllAg.Pancreas_and_brain [Chip-atlas[Archive

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Lifescience Database Archive (English)

Full Text Available Unc.Oth.50.AllAg.Pancreas_and_brain mm9 Unclassified Others Pancreas and brain SRX1...125800 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Oth.50.AllAg.Pancreas_and_brain.bed ...

Detection of experimental pancreas necrosis by DNA-ase labelled with radioiodine

International Nuclear Information System (INIS)

Tihanyi, Tibor; Duffek, Laszlo; Balint, Istvan; Flautner, Lajos

1986-01-01

Detection of pancreas necrosis was attempted in dog experiments. Strong association between pancreatic DNA-ase and actin molecules in vitro provided the theoretical basis for the procedure. Pancreatic DNA-ase labelled with 125 I was administered intravenously to dogs in which experimental pancreas necrosis was elicited. Accumulation ratio of radioactivity was above 20 in the necrotic pancreas whereas it varied between 1.6 and 5.6 in other tissues. After administration of 37 MBq 131 I labelled DNA-ase, accumulation of radioactivity could be clearly visualized in the necrotic portions of the removed pancreas by a gamma camera. The investigations will be extended in order to develop a clinically utilizable test. (L.E.)

File list: ALL.Oth.20.AllAg.Pancreas_and_brain [Chip-atlas[Archive

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File list: ALL.Oth.10.AllAg.Pancreas_and_brain [Chip-atlas[Archive

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File list: ALL.Oth.50.AllAg.Pancreas_and_brain [Chip-atlas[Archive

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File list: ALL.Oth.05.AllAg.Pancreas_and_brain [Chip-atlas[Archive

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Lymphangioma in pancreas: a case and literature revision

International Nuclear Information System (INIS)

Moreno-Flores, A.; Alos Company, M.J.; Solera Beltran, M.C.; Ricart Rodigro, M.; Lazaro Ventura, A.; Selfa Moreno, S.

1993-01-01

While lymphangioma is a relatively common benign tumor, it is not often located in pancreas, with less than 30 such cases published in the literature. The laboratory clinical and radiological findings are nonspecific, for which reason the definitive diagnosis is based on the pathological findings. We present the case of a patient with cystic lymphangioma of the pancreas and review the radiological findings reported in the literature. (Author)

Endoscopic techniques for diagnosis and correction of complications after retroperitoneal pancreas transplantation

Directory of Open Access Journals (Sweden)

A. V. Pinchuk

2016-01-01

Full Text Available Relevance. Timely diagnosis and treatment of postoperative complications after pancreas transplantation is an actual problem of modern clinical transplantation. Purpose. The assessment of the endoscopy potential for the diagnosis and correction of postoperative complications after pancreas transplantation. Materials and methods. Since October 2011, simultaneous retroperitoneal pancreas-kidney transplantation has been performed in 27 patients. In 8 cases, the use of endoscopic techniques allowed a timely identification and treatment of the complications occurred. Conclusions. Endoscopic techniques proved to be highly efficient in the diagnosis and treatment of surgical complications and immunological impairments after retroperitoneal pancreas transplantation. 

A critical review and analysis of ethical issues associated with the artificial pancreas.

Science.gov (United States)

Quintal, A; Messier, V; Rabasa-Lhoret, R; Racine, E

2018-04-25

The artificial pancreas combines a hormone infusion pump with a continuous glucose monitoring device, supported by a dosing algorithm currently installed on the pump. It allows for dynamic infusions of insulin (and possibly other hormones such as glucagon) tailored to patient needs. For patients with type 1 diabetes the artificial pancreas has been shown to prevent more effectively hypoglycaemic events and hyperglycaemia than insulin pump therapy and has the potential to simplify care. However, the potential ethical issues associated with the upcoming integration of the artificial pancreas into clinical practice have not yet been discussed. Our objective was to identify and articulate ethical issues associated with artificial pancreas use for patients, healthcare professionals, industry and policymakers. We performed a literature review to identify clinical, psychosocial and technical issues raised by the artificial pancreas and subsequently analysed them through a common bioethics framework. We identified five sensitive domains of ethical issues. Patient confidentiality and safety can be jeopardized by the artificial pancreas' vulnerability to security breaches or unauthorized data sharing. Public and private coverage of the artificial pancreas could be cost-effective and warranted. Patient selection criteria need to ensure equitable access and sensitivity to patient-reported outcomes. Patient coaching and support by healthcare professionals or industry representatives could help foster realistic expectations in patients. Finally, the artificial pancreas increases the visibility of diabetes and could generate issues related to personal identity and patient agency. The timely consideration of these issues will optimize the technological development and clinical uptake of the artificial pancreas. Copyright © 2018. Published by Elsevier Masson SAS.

Torsion of wandering spleen and distal pancreas

International Nuclear Information System (INIS)

Sheflin, J.R.; Lee, C.M.; Kretchmar, K.A.

1984-01-01

Wandering spleen is the term applied to the condition in which a long pedicle allows the spleen to lie in an abnormal location. Torsion of a wandering spleen is an unusual cause of an acute abdomen and is rarely diagnosed preoperatively. Associated torsion of the distal pancreas is even more uncommon. The authors describe a patient with torsion of a wandering spleen and distal pancreas, who was correctly diagnosed, and define the merits of the imaging methods used. The initial examination should be 99 /sup m/Tc-sulfur colloid liner-spleen scanning

Imaging of the pancreas using dynamic positron emission tomography with N-13 ammonia

International Nuclear Information System (INIS)

Hayashi, N.; Tamaki, N.; Yonekura, Y.; Adachi, H.; Senda, M.; Saji, H.; Torizuka, K.

1985-01-01

This study was undertaken to develop a new imaging technique of the pancreas. Dynamic positron emission tomography (PET) was performed in 3 normal volunteers, 9 patient without the evidence of pancreatic diseases, 2 patients with adenocarcinoma of the pancreatic head and one patient with islet cell carcinoma. Immediately after the intravenous injection of 10-20mCi of N-13 ammonia, data were obtained every 150 seconds for 30 minutes using a multi-slice whole-body PET scanner. In two cases of adenocarcinoma, the pancreas was not imaged, probably because the nontumorous portion of the pancreas was also suffered from severe pancreatitis due to the duct obstruction at the pancreatic head. In the case with islet cell carcinoma, the radionuclide was accumulated in the tumor and pancreas similarly. Thus, both of them were visualized but not separated. The central necrosis of the tumor showed poor radioactivity. The mechanism of the radionuclide accumulation in the pancreas is not well understood. However, the authors also studied the biodistribution of N-13 ammonia in mice and confirmed that there is an early and high accumulation of the radionuclide in the murine pancreas. These preliminary results of this paper suggest that the dynamic PET study may be useful for the imaging of the pancreas as well as for the further study of the blood supply and metabolism of the pancreas

The roles of the liver and pancreas in renal nutcracker syndrome

Energy Technology Data Exchange (ETDEWEB)

Yun, Seong Jong, E-mail: zoomknight@naver.com [Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 149 Sangil-dong, Kangdong-gu, Seoul 134-727 (Korea, Republic of); Department of Radiology, Graduate School of Medicine, Kyung Hee University, Hoegi-dong, Dongdaemun-gu, Seoul 130-701 (Korea, Republic of); Nam, Deok Ho, E-mail: namjindan@daum.net [Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 149 Sangil-dong, Kangdong-gu, Seoul 134-727 (Korea, Republic of); Ryu, Jung Kyu, E-mail: oddie2@naver.com [Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 149 Sangil-dong, Kangdong-gu, Seoul 134-727 (Korea, Republic of); Kim, Ji Su, E-mail: js830808@hanmail.net [Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 149 Sangil-dong, Kangdong-gu, Seoul 134-727 (Korea, Republic of)

2014-10-15

Graphical abstract: - Highlights: • The presence of the liver and pancreas may influence NCS by compressing SMA against the aorta. • The presence of the liver and pancreas at the level of the LRV is not yet recognized as an independent factor for NCS but should be. • The presence of the liver and the pancreas may allow clinicians to identify NCS patients and may influence the choice of treatment options. - Abstract: Introduction: To assess the frequency and significance of presence of the liver and pancreas at the left renal vein (LRV) level in patients with suspected renal nutcracker syndrome (NCS). Materials and methods: We included 101 patients with hematuria who underwent urography three-dimensional CT between April 2009 and November 2013. These patients were divided into NCS (n = 25) and non-NCS (n = 76) patients according to the following CT criteria: (1) the presence of beak sign and (2) hilar-aortomesenteric left renal vein diameter ratio >4. Patients were grouped according to the presence of the liver and pancreas at the LRV: group LP (both liver and pancreas), group L (only liver), group P (only pancreas), and group O (neither liver nor pancreas). The difference in the frequencies of groups was analyzed between NCS and non-NCS patients. Multivariate analysis was used to determine the independent factors between NCS and non-NCS patients. Results: The frequencies of group LP, group L, group P, and group O in NCS vs. non-NCS were 88% vs. 5.3% (p < 0.001), 4.0% vs. 2.6% (p = 0.75), 4.0% vs. 11.8% (p = 0.45), 4.0% vs. 80.3% (p < 0.001), respectively. Multivariate analysis demonstrated that group was a predictor for differential diagnosis between NCS and non-NCS (p = 0.022), and group LP was an independent factor for the presence of NCS (odds ratio, 43.8; 95% confidence interval, 3.8–500.3; p < 0.002; reference, group O). Conclusion: The presence of the liver and pancreas at the level of the LRV was frequently found in NCS and was the independent factor

The roles of the liver and pancreas in renal nutcracker syndrome

International Nuclear Information System (INIS)

Yun, Seong Jong; Nam, Deok Ho; Ryu, Jung Kyu; Kim, Ji Su

2014-01-01

Graphical abstract: - Highlights: • The presence of the liver and pancreas may influence NCS by compressing SMA against the aorta. • The presence of the liver and pancreas at the level of the LRV is not yet recognized as an independent factor for NCS but should be. • The presence of the liver and the pancreas may allow clinicians to identify NCS patients and may influence the choice of treatment options. - Abstract: Introduction: To assess the frequency and significance of presence of the liver and pancreas at the left renal vein (LRV) level in patients with suspected renal nutcracker syndrome (NCS). Materials and methods: We included 101 patients with hematuria who underwent urography three-dimensional CT between April 2009 and November 2013. These patients were divided into NCS (n = 25) and non-NCS (n = 76) patients according to the following CT criteria: (1) the presence of beak sign and (2) hilar-aortomesenteric left renal vein diameter ratio >4. Patients were grouped according to the presence of the liver and pancreas at the LRV: group LP (both liver and pancreas), group L (only liver), group P (only pancreas), and group O (neither liver nor pancreas). The difference in the frequencies of groups was analyzed between NCS and non-NCS patients. Multivariate analysis was used to determine the independent factors between NCS and non-NCS patients. Results: The frequencies of group LP, group L, group P, and group O in NCS vs. non-NCS were 88% vs. 5.3% (p < 0.001), 4.0% vs. 2.6% (p = 0.75), 4.0% vs. 11.8% (p = 0.45), 4.0% vs. 80.3% (p < 0.001), respectively. Multivariate analysis demonstrated that group was a predictor for differential diagnosis between NCS and non-NCS (p = 0.022), and group LP was an independent factor for the presence of NCS (odds ratio, 43.8; 95% confidence interval, 3.8–500.3; p < 0.002; reference, group O). Conclusion: The presence of the liver and pancreas at the level of the LRV was frequently found in NCS and was the independent factor

Focal uptake of 68Ga-DOTATOC in the pancreas: pathological or physiological correlate in patients with neuroendocrine tumours?

International Nuclear Information System (INIS)

Al-Ibraheem, Akram; Bundschuh, Ralph Alexander; Notni, Johannes; Winter, Anna; Wester, Hans-Juergen; Schwaiger, Markus; Scheidhauer, Klemens; Buck, Andreas

2011-01-01

Neuroendocrine tumours are frequently located in the upper abdomen and especially in the pancreas. Imaging of the abdomen with somatostatin analogs such as 68 Ga-DOTA-Phe 1 -Tyr 3 -octreotide (DOTATOC) is a standard approach for imaging neuroendocrine cancer, but is still challenging due to physiological and technical considerations in this area. Therefore, the aim of this study was to further investigate the origin of 68 Ga-DOTATOC findings in the pancreas. Forty-three consecutive patients with neuroendocrine tumours were examined by 68 Ga-DOTATOC positron emission tomography (PET)/CT for staging or restaging. As imaging of the upper abdomen is frequently affected by breathing artefacts, PET and CT data were analysed for misalignment and rearranged if necessary. Any noticeable uptake in the pancreas was described. Tracer uptake in the head of the pancreas and the liver was measured by means of maximum and average standard uptake value (SUV max , SUV av ). The reference standards (malignant versus benign) for correlation with PET findings were clinical and radiological follow-up (mean follow-up time 14 months) (n = 37) or histological confirmation (n = 6). In 23 of 43 studies (54%) misalignment between PET and CT data was found with a mean value of 1.4 cm. Visual assessment demonstrated that 20 of 43 scans (46.6%) showed no uptake in the head of the pancreas. Of 43 scans, 23 (53.4%) showed noticeable uptake with focal pattern in the head of the pancreas in 10 scans and irregular pattern in 13 scans. Follow-up indicated malignant pancreatic lesions in three patients. The pancreatic head to liver SUV av ratios in these patients ranged from 1.62 to 6.85, whereas in cases of uptake without known malignancy ratios ranged from 0.56 to 1.19. Considering SUV max , the ratio ranged from 3.24 to 9.1 and from 0.84 to 1.47, respectively. No statistically significant difference was noted between uptake in the head of the pancreas and the liver in patients without malignant

Evaluation of pancreatic cancer by multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging at 3.0 T

International Nuclear Information System (INIS)

Yao, Xiuzhong; Zeng, Mengsu; Wang, He; Sun, Fei; Rao, Shengxiang; Ji, Yuan

2012-01-01

Objective: To investigate the microcirculation in pancreatic cancer by pharmacokinetic analysis of multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging at 3.0 T. Materials and methods: Multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging was performed in 40 healthy volunteers and 40 patients with pancreatic cancer proven by histopathology using an axial three-dimensions fat-saturated T1-weighted spoiled-gradient echo sequence at 3.0 T. A two compartment model with T1 correction was used to quantify the transfer constant, the rate constant of backflux from the extravascular extracellular space to the plasma and the extravascular extracellular space fractional volume in pancreatic cancer, obstructive pancreatitis distal to the malignant tumor, adjacent pancreatic tissue proximal to the tumor and normal pancreas. All parameters were statistically analyzed. Results: Statistical differences were noticed in both the transfer constant (p = 0.000075) and the rate constant of backflux (p = 0.006) among different tissues. Both the transfer constant and the rate constant of backflux in pancreatic cancer were statistically lower than those in normal pancreas and adjacent pancreatic tissue (p < 0.05). Both the transfer constant and the rate constant of backflux in obstructive pancreatitis were statistically lower than those in normal pancreas and adjacent pancreatic tissue (p < 0.05). The extravascular extracellular space fractional volume in pancreatic cancer was statistically lager than that in normal pancreas (p = 0.002). Conclusion: Multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging offers a useful technique to evaluate the microenvironment in pancreatic cancer at 3.0 T. Compared to normal pancreas, pancreatic cancer has lower transfer constant, rate constant of backflux and larger extravascular extracellular space fractional volume.

Evaluation of pancreatic cancer by multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging at 3.0 T

Energy Technology Data Exchange (ETDEWEB)

Yao, Xiuzhong, E-mail: yao.xiuzhong@zs-hospital.sh.cn [Department of Radiology, Zhongshan Hospital of Fudan University and Department of Medical Image, Shanghai Medical College of Fudan University, No. 138, Fenglin Road, Xuhui District, Shanghai 200032 (China); Zeng, Mengsu, E-mail: zengmengsu@gmail.com [Department of Radiology, Zhongshan Hospital of Fudan University and Department of Medical Image, Shanghai Medical College of Fudan University, No. 138, Fenglin Road, Xuhui District, Shanghai 200032 (China); Wang, He, E-mail: herry258@hotmail.com [Global Applied Science Laboratory of GE Healthcare, No. 1, Huatuo Road, Zhangjiang Hi-tech Park, Pudong District, Shanghai 201203 (China); Sun, Fei, E-mail: fei.sun@med.ge.com [Global Applied Science Laboratory of GE Healthcare, No. 1, Huatuo Road, Zhangjiang Hi-tech Park, Pudong District, Shanghai 201203 (China); Rao, Shengxiang, E-mail: rao.shengxiang@zs-hospital.sh.cn [Department of Radiology, Zhongshan Hospital of Fudan University and Department of Medical Image, Shanghai Medical College of Fudan University, No. 138, Fenglin Road, Xuhui District, Shanghai 200032 (China); Ji, Yuan, E-mail: Ji.yuan@zs-hospital.sh.cn [Department of Pathology, Zhongshan Hospital of Fudan University, No. 138, Fenglin Road, Xuhui District, Shanghai 200032 (China)

2012-08-15

Objective: To investigate the microcirculation in pancreatic cancer by pharmacokinetic analysis of multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging at 3.0 T. Materials and methods: Multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging was performed in 40 healthy volunteers and 40 patients with pancreatic cancer proven by histopathology using an axial three-dimensions fat-saturated T1-weighted spoiled-gradient echo sequence at 3.0 T. A two compartment model with T1 correction was used to quantify the transfer constant, the rate constant of backflux from the extravascular extracellular space to the plasma and the extravascular extracellular space fractional volume in pancreatic cancer, obstructive pancreatitis distal to the malignant tumor, adjacent pancreatic tissue proximal to the tumor and normal pancreas. All parameters were statistically analyzed. Results: Statistical differences were noticed in both the transfer constant (p = 0.000075) and the rate constant of backflux (p = 0.006) among different tissues. Both the transfer constant and the rate constant of backflux in pancreatic cancer were statistically lower than those in normal pancreas and adjacent pancreatic tissue (p < 0.05). Both the transfer constant and the rate constant of backflux in obstructive pancreatitis were statistically lower than those in normal pancreas and adjacent pancreatic tissue (p < 0.05). The extravascular extracellular space fractional volume in pancreatic cancer was statistically lager than that in normal pancreas (p = 0.002). Conclusion: Multiple breath-hold dynamic contrast-enhanced magnetic resonance imaging offers a useful technique to evaluate the microenvironment in pancreatic cancer at 3.0 T. Compared to normal pancreas, pancreatic cancer has lower transfer constant, rate constant of backflux and larger extravascular extracellular space fractional volume.

Pancreas transplants

International Nuclear Information System (INIS)

Chandra, J.; Phillips, R.R.; Boardman, P.; Gleeson, F.V.; Anderson, E.M.

2009-01-01

Cadaveric, whole pancreas transplantation has proved an effective therapy in the treatment of long-standing type 1 diabetes mellitus and is capable of achieving an insulin-independent eugyclaemic state. As a result, this procedure is being increasingly performed. However, the surgical procedure is complex and unfamiliar to many radiologists. Imaging with computed tomography (CT) and magnetic resonance imaging (MRI) gives excellent results and can be used confidently to diagnose vascular, enteric, and immune-mediated complications. We present a review of the normal post-transplantation appearance and the features of early and late complications.

Pancreas transplants

Energy Technology Data Exchange (ETDEWEB)

Chandra, J.; Phillips, R.R.; Boardman, P.; Gleeson, F.V. [Department of Radiology, Churchill Hospital, Headington, Oxford (United Kingdom); Anderson, E.M. [Department of Radiology, Churchill Hospital, Headington, Oxford (United Kingdom)], E-mail: ewan.anderson@orh.nhs.uk

2009-07-15

Cadaveric, whole pancreas transplantation has proved an effective therapy in the treatment of long-standing type 1 diabetes mellitus and is capable of achieving an insulin-independent eugyclaemic state. As a result, this procedure is being increasingly performed. However, the surgical procedure is complex and unfamiliar to many radiologists. Imaging with computed tomography (CT) and magnetic resonance imaging (MRI) gives excellent results and can be used confidently to diagnose vascular, enteric, and immune-mediated complications. We present a review of the normal post-transplantation appearance and the features of early and late complications.

Pancreas grafts

International Nuclear Information System (INIS)

Hahn, D.; Buell, U.; Land, W.; Unertl, K.

1981-01-01

Perfusion studies with sup(99m)Tc-DTPA, which has hitherto been used routinely to investigate renal grafts, have also proved useful for monitoring the perfusion of pancreas grafts. A total perfusion failure is equally reliably demonstrable as in renal grafts. Quantitatively smaller perfusion alterations can be demonstrated by monitoring the course. It seems possible to differentiate the salivary edema of a rejection reaction, well known from animal experiments, with the help of other paramters (e.g. creatinine). Further clinical studies are however necessary to confirm these results. (orig.) [de

Solid and cystic pseudopapillary tumor of the pancreas: A case report

Directory of Open Access Journals (Sweden)

Milošević Bojan Z.

2013-01-01

Full Text Available Introduction. Solid and cystic pseudopapillary tumor of the pancreas is a rare tumor of the pancreas, for the first time described by Frantz et al. in 1959. The majority of patients are young females and most of them are asymptomatic. Case Outline. We report a case of 25-year old woman who was admitted to our institution with abdominal pain and a palpable mass in the left hypochondrial area. US and CT scan revealed a solid and cystic pseudopapillary tumor in the head of the pancreas. The patient was treated by Whipple procedure, modification Longmire-Traverso. There was no metastatic disease either in the liver or peritoneum. Histologically the tumor was diagnosed as a solid and cystic pseudopapillary tumor of the pancreas. Conclusion. The unclear pre-operative diagnoses, together with incidence of potential malignancy as well as good outcome with resection, suggest that all suspected cystic tumors of the pancreas should be resected. The exact diagnosis is based on histological findings. [Projekat Ministarstva nauke Republike Srbije, br. III41007 i br. III41010

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

Science.gov (United States)

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

2014-10-01

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.

Carcinoma of the pancreas

International Nuclear Information System (INIS)

Humphrey, L.J.; Hartman, G.V.

1974-01-01

Experience with 17 patients with incurable carcinoma of the pancreas treated by radiation therapy and immunotherapy is described. Results observed have prompted a program of aggressive surgery, radiation therapy, immunotherapy, and long-term chemotherapy. Optimism for significant palliation and survival for these patients with curable and incurable pancreatic carcinoma is warranted. (U.S.)

Pancreas-sparing duodenectomy for an obstructive adenocarcinoma of the duodenum.

Science.gov (United States)

Lam, D; Croome, Kp; Hernandez-Alejandro, R

2012-08-01

A duodenal adenocarcinoma arising from the junction of the second and third portion of the duodenum, which was resected by pancreas-sparing duodenectomy, is reported. The completely obstructing tumour was circumferential and measured 6.5cm x 3.5cm x 1.0 cm. There was no evidence of pancreas invasion, nor any lymph node metastasis. Pancreas-sparing duodenectomy was performed, with dissection of the pancreaticoduodenal lymph nodes. The proximal duodenum was transected just distal to the ampula of Vater and jejunum was transected just distal to the ligament of Treitz. A hand-sewn side-to-side anastomosis for the duodenojejunostomy was performed. There were no postoperative complications. Pathology reported a duodenal adenocarcinoma resected with negative margins. Pancreaticoduodenectomy is the treatment of choice for a duodenal adenocarcinoma, however, pancreas-sparing duodenectomy may be a safe alternative for duodenal tumours not involving the 2(nd) portion, especially in elderly patients with multiple medical comorbidities. © JSCR.

Solid-pseudo papillary tumor of the pancreas: Frantz's tumor

International Nuclear Information System (INIS)

Oliveira, Bruno Righi Rodrigues de; Moreira, Reni Cecilia Lopes; Campos, Marcelo Esteves Chaves

2010-01-01

The pseudo papillary solid tumor of the pancreas, also known as Frantz's tumor, is a rare disease, taking place in approximately 0.17% to 2.7% of non-endocrine tumors of the pancreas. Recently, the increase of its incidence has been noted with more than two-thirds of the total cases described in the last 10 years. A possible explanation is a greater knowledge of the disease and a greater uniformity of conceptualization in the last years. Generally, it affects young adult females. In most of the series, the tumor principally attacks the body and tail of the pancreas. The objective of the present report is to present the diagnostic and therapeutic option used in this rare pancreatic tumor of low-grade malignancy. (author)

Temperature profiles of different cooling methods in porcine pancreas procurement.

Science.gov (United States)

Weegman, Bradley P; Suszynski, Thomas M; Scott, William E; Ferrer Fábrega, Joana; Avgoustiniatos, Efstathios S; Anazawa, Takayuki; O'Brien, Timothy D; Rizzari, Michael D; Karatzas, Theodore; Jie, Tun; Sutherland, David E R; Hering, Bernhard J; Papas, Klearchos K

2014-01-01

Porcine islet xenotransplantation is a promising alternative to human islet allotransplantation. Porcine pancreas cooling needs to be optimized to reduce the warm ischemia time (WIT) following donation after cardiac death, which is associated with poorer islet isolation outcomes. This study examines the effect of four different cooling Methods on core porcine pancreas temperature (n = 24) and histopathology (n = 16). All Methods involved surface cooling with crushed ice and chilled irrigation. Method A, which is the standard for porcine pancreas procurement, used only surface cooling. Method B involved an intravascular flush with cold solution through the pancreas arterial system. Method C involved an intraductal infusion with cold solution through the major pancreatic duct, and Method D combined all three cooling Methods. Surface cooling alone (Method A) gradually decreased core pancreas temperature to <10 °C after 30 min. Using an intravascular flush (Method B) improved cooling during the entire duration of procurement, but incorporating an intraductal infusion (Method C) rapidly reduced core temperature 15-20 °C within the first 2 min of cooling. Combining all methods (Method D) was the most effective at rapidly reducing temperature and providing sustained cooling throughout the duration of procurement, although the recorded WIT was not different between Methods (P = 0.36). Histological scores were different between the cooling Methods (P = 0.02) and the worst with Method A. There were differences in histological scores between Methods A and C (P = 0.02) and Methods A and D (P = 0.02), but not between Methods C and D (P = 0.95), which may highlight the importance of early cooling using an intraductal infusion. In conclusion, surface cooling alone cannot rapidly cool large (porcine or human) pancreata. Additional cooling with an intravascular flush and intraductal infusion results in improved core porcine pancreas temperature profiles during procurement and

Acid-base transport in pancreas-new challenges

DEFF Research Database (Denmark)

Novak, Ivana; Haanes, Kristian Agmund; Wang, Jing

2013-01-01

Along the gastrointestinal tract a number of epithelia contribute with acid or basic secretions in order to aid digestive processes. The stomach and pancreas are the most extreme examples of acid (H+) and base (HCO-3) transporters, respectively. Nevertheless, they share the same challenges...... to consider in pancreas are the proton pumps (H-K-ATPases), as well as the calcium-activated K and Cl channels, such as K3.1 and TMEM16A/ANO1. Local regulators, such as purinergic signaling, fine-tune, and coordinate pancreatic secretion. Lastly, we speculate whether dys-regulation of acid-base transport...

[The physiology of the isolated dog pancreas--the influence of the actual blood glucose level on the blood circulation in the pancreas].

Science.gov (United States)

Hempfling, H; Husemann, B

1975-06-01

1. Glucose loading tests were undertaken on isolated pancreas or pancreas-duodenal preparations. 2. In 75% of cases a vasodilatation can be observed which leads to enhanced blood circulation under constant pressure in the isolated organ. 3. This vasodilatation persists until the level of blood sugar has normalized. 4. The experiment being carried out on an isolated organ, external factors such as the vagus nerve, do not become active.

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

Directory of Open Access Journals (Sweden)

Yueh-Tsung Lee

2012-11-01

Full Text Available 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.

File list: InP.Oth.20.AllAg.Pancreas_and_brain [Chip-atlas[Archive

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Full Text Available InP.Oth.10.AllAg.Pancreas_and_brain mm9 Input control Others Pancreas and brain htt...p://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/InP.Oth.10.AllAg.Pancreas_and_brain.bed ...

An epidermoid cyst of accessory spleen simulating tumors of the tail of pancreas

Directory of Open Access Journals (Sweden)

Amit Kumar Sinha

2015-07-01

Full Text Available An epidermoid cyst of accessory spleen, a rare condition may present as pseudocyst of pancreas and other cystic tumors of the pancreas. This case report along with the review of literature attributes some clinical features and investigative pattern to differentiate between epidermoid cyst of accessory spleen and other cystic tumor of pancreas.

In Vitro-Produced Pancreas Organogenesis Models In Three Dimensions

DEFF Research Database (Denmark)

Greggio, Chiara; De Franceschi, Filippo; Grapin-Botton, Anne

2015-01-01

of miniature organs in a dish and are emerging for the pancreas, starting from embryonic progenitors and adult cells. This review focusses on the currently available systems and how these allow new types of questions to be addressed. We discuss the expected advancements including their potential to study human...... pancreas development and function as well as to develop diabetes models and therapeutic cells. Stem Cells 2014....

Computed tomographic evaluation of the altered pancreas in dog and cat

International Nuclear Information System (INIS)

Posch, B.

2002-11-01

Eighteen dogs and 12 cats of varying breed, age and sex underwent a computed tomographic study of the pancreas. Length, diameter and density of each lobe of the pancreas were measured. Further, the gained results were compared to the information established by the clinical examination, sonography, haematology and histology. Contrast CT improved evaluation of the pancreas in all cases of normal life controls. CT criteria such as changes in size, density, delimitation of the pancreas and the peripancreatic structures were analyzed. Increased pancreatic size was seen in inflammatory as well as in neoplastic diseases. There were no reliable computed tomographic criteria to differentiate pancreatic neoplasia from inflammation without peripancreatic findings. Ultrasonography proved to be a good screening method in this study: sonographic and computed tomographic results correlated in all cases with the exception of 5 cases. In contrast to ultrasonography CT could differentiate normal pancreas from pancreas atrophy. Computed tomography was superior to sonography in determining the full extent of pancreatic and peripancreatic signs due to the good overview and overall image of the abdominal structures. Serum chemistry of a- amylase and lipase were obtained in 28 animals. Assays of serum lipase and a- amylase activities were only able to detect acute pancreatitis in half of the canine cases. Despite morphological alterations detected with the help of sonography or CT, there were no significant increases in a- amylase and lipase in cats. Following computed tomography the pancreas of 10 animals was examined pathohistologically. With the exception of 2 cases the computed tomographic results correlated with the pathohistological findings. In conclusion, computed tomography (CT) proved to be a valuable method to evaluate the localization, the full extent and the seriousness of pancreatic lesions. (author)

Gadolinium DTPA as oral contrast medium for MRT of the pancreas

International Nuclear Information System (INIS)

Neumann, K.; Kaminsky, S.; Gogoll, M.; Langer, M.; Felix, R.

1991-01-01

52 patients with normal pancreas, pancreatitis and pancreatic tumors were examined by magnetic resonance imaging (Magnetom 0,5 T). Using T 1 -, proton density- and T 2 -weighted spin-echo sequences images were obtained before and after oral administration of Gadolinium-DTPA (Gd-DTPA, 1 mM, 15 g/l Mannit, 5-13 ml/kg). Gd-DTPA resulted in hyperintense labeling of small bowel in all sequences and improved visualization of pancreatic head, body and tail in 15, 14 and 7 of 27 patients with normal pancreas and in 17, 8 and 6 of 25 patients with diseased pancreas. Better delineation of pseudocysts and tumorous gut wall invasion were diagnostically profitable. With regard to motion artifact reduced MRI of the intestine using fast sequences Gd-DTPA may be a suitable oral contrast agent to improve the imaging of the pancreas. (orig.) [de

Neurofunctional imaging of the pancreas utilizing the cholinergic PET radioligand [18F]4-fluorobenzyltrozamicol

International Nuclear Information System (INIS)

Clark, P.B.; Gage, H.D.; Brown-Proctor, C.; Buchheimer, N.; Morton, K.A.; Calles-Escandon, J.; Mach, R.H.

2004-01-01

The pancreas is one of the most heavily innervated peripheral organs in the body. Parasympathetic and sympathetic neurons terminate in the pancreas and provide tight control of endocrine and exocrine functions. The aim of this study was to determine whether the pancreas can be imaged with a radioligand that binds to specific neuroreceptors. Using fluorine-18 4-fluorobenzyltrozamicol (FBT), which binds to the presynaptic vesicular acetylcholine transporter, positron emission tomography scans were performed in four adult mice, two adult rhesus monkeys, and one adult human. In these mammals, the pancreas is intensely FBT avid, with uptake greater than in any other organ at 30, 60, and 90 min. The maximum standardized uptake value (SUV) ratios of pancreas to liver, for example, ranged from 1.4 to 1.7 in rhesus monkeys (mean 1.6; median 1.7) and from 1.9 to 4.7 (mean 3.24; median 3.02) in mice. The maximum SUV ratio of pancreas to liver in the human was 1.8. These data suggest that neuroreceptor imaging of the pancreas in vivo is feasible in animal models and humans. This imaging could allow researchers to interrogate functions under control of the autonomic nervous system in the pancreas, with applications possible in transplanted and native pancreata. Also, as beta cell function is intimately related to parasympathetic cholinergic input, FBT activity in the pancreas may correlate with insulin-producing beta cell mass. This could ultimately provide a method of in vivo imaging in animal models and humans for diabetes research. (orig.)

Increased pancreatic cancer risk following radiotherapy for testicular cancer

DEFF Research Database (Denmark)

Hauptmann, Michael; Børge Johannesen, Tom; Gilbert, Ethel S

2016-01-01

with the number of cycles of chemotherapy with alkylating or platinum agents (P=0.057), although only one case was exposed to platinum. CONCLUSIONS: A dose-response relationship exists between radiation to the pancreas and subsequent cancer risk, and persists for over 20 years. These excesses, although small...

Diffusion-weighted imaging of the pancreas; Diffusionsbildgebung des Pankreas

Energy Technology Data Exchange (ETDEWEB)

Gruenberg, K. [Deutsches Krebsforschungszentrum (DKFZ) Heidelberg, Abteilung Radiologie, E010, Heidelberg (Germany); Grenacher, L.; Klauss, M. [Universitaetsklinikum Heidelberg, Abt. Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

2011-03-15

Diffusion-weighted imaging (DWI) has increasingly gained in importance over the last 10 years especially in cancer imaging for differentiation of malignant and benign lesions. Through development of fast magnetic resonance imaging (MRI) sequences DWI is not only applicable in neuroradiology but also in abdominal imaging. As a diagnostic tool of the pancreas DWI enables a differentiation between normal tissue, cancer and chronic pancreatitis. The ADC values (apparent diffusion coefficient, the so-called effective diffusion coefficient) reported in the literature for healthy pancreatic tissue are in the range from 1.49 to 1.9 x 10{sup -3} mm{sup 2}/s, for pancreatic cancer in the range from 1.24 to 1.46 x 10{sup -3} mm{sup 2}/s and for autoimmune pancreatitis an average ADC value of 1.012 x 10{sup -3} mm{sup 2}/s. There are controversial data in the literature concerning the differentiation between chronic pancreatitis and pancreatic cancer. Using DWI-derived IVIM (intravoxel incoherent motion) the parameter f (perfusion fraction) seems to be advantageous but it is important to use several b values. In the literature the mean f value in chronic pancreatitis is around 16%, in pancreatic cancer 8% and in healthy pancreatic tissue around 25%. So far, DWI has not been helpful for differentiating cystic lesions of the pancreas. There are many references with other tumor entities and in animal models which indicate that there is a possible benefit of DWI in monitoring therapy of pancreatic cancer but so far no original work has been published. (orig.) [German] Die Diffusionsbildgebung (''diffusion-weighted imaging'', DWI) gewann in den letzten 10 Jahren insbesondere in der Tumorbildgebung zur Unterscheidung zwischen malignen und benignen Laesionen zunehmend an Bedeutung. Durch Entwicklung schnellerer MR-Sequenzen ist sie nicht nur in der Neuroradiologie, sondern auch in der Abdomenbildgebung einsetzbar. In der Pankreasdiagnostik ermoeglicht sie

Insulin/IGF-driven cancer cell-stroma crosstalk as a novel therapeutic target in pancreatic cancer.

Science.gov (United States)

Mutgan, Ayse Ceren; Besikcioglu, H Erdinc; Wang, Shenghan; Friess, Helmut; Ceyhan, Güralp O; Demir, Ihsan Ekin

2018-02-23

Pancreatic ductal adenocarcinoma (PDAC) is unrivalled the deadliest gastrointestinal cancer in the western world. There is substantial evidence implying that insulin and insulin-like growth factor (IGF) signaling axis prompt PDAC into an advanced stage by enhancing tumor growth, metastasis and by driving therapy resistance. Numerous efforts have been made to block Insulin/IGF signaling pathway in cancer therapy. However, therapies that target the IGF1 receptor (IGF-1R) and IGF subtypes (IGF-1 and IGF-2) have been repeatedly unsuccessful. This failure may not only be due to the complexity and homology that is shared by Insulin and IGF receptors, but also due to the complex stroma-cancer interactions in the pancreas. Shedding light on the interactions between the endocrine/exocrine pancreas and the stroma in PDAC is likely to steer us toward the development of novel treatments. In this review, we highlight the stroma-derived IGF signaling and IGF-binding proteins as potential novel therapeutic targets in PDAC.

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Full Text Available Unc.Pan.50.AllAg.Pancreatic_cancer_cells mm9 Unclassified Pancreas Pancreatic cancer... cells http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Pan.50.AllAg.Pancreatic_cancer_cells.bed ...

Screening Technologies for Target Identification in Pancreatic Cancer

Energy Technology Data Exchange (ETDEWEB)

Michl, Patrick, E-mail: michlp@med.uni-marburg.de; Ripka, Stefanie; Gress, Thomas; Buchholz, Malte [Department of Gastroenterology and Endocrinology, University Hospital, Philipps-University Marburg, Baldinger Strasse, D-35043 Marburg (Germany)

2010-12-29

Pancreatic cancer exhibits an extraordinarily high level of resistance to almost any kind of systemic therapy evaluated in clinical trials so far. Therefore, the identification of novel therapeutic targets is urgently required. High-throughput screens have emerged as an important tool to identify putative targets for diagnosis and therapy in an unbiased manner. More than a decade ago, microarray technology was introduced to identify differentially expressed genes in pancreatic cancer as compared to normal pancreas, chronic pancreatitis and other cancer types located in close proximity to the pancreas. In addition, proteomic screens have facilitated the identification of differentially secreted proteins in body fluids of pancreatic cancer patients, serving as possible biomarkers. Recently, RNA interference-based loss-of-function screens have been used to identify functionally relevant genes, whose knock-down has impact on pancreatic cancer cell viability, thereby representing potential new targets for therapeutic intervention. This review summarizes recent results of transcriptional, proteomic and functional screens in pancreatic cancer and discusses potentials and limitations of the respective technologies as well as their impact on future therapeutic developments.

Screening Technologies for Target Identification in Pancreatic Cancer

International Nuclear Information System (INIS)

Michl, Patrick; Ripka, Stefanie; Gress, Thomas; Buchholz, Malte

2010-01-01

Pancreatic cancer exhibits an extraordinarily high level of resistance to almost any kind of systemic therapy evaluated in clinical trials so far. Therefore, the identification of novel therapeutic targets is urgently required. High-throughput screens have emerged as an important tool to identify putative targets for diagnosis and therapy in an unbiased manner. More than a decade ago, microarray technology was introduced to identify differentially expressed genes in pancreatic cancer as compared to normal pancreas, chronic pancreatitis and other cancer types located in close proximity to the pancreas. In addition, proteomic screens have facilitated the identification of differentially secreted proteins in body fluids of pancreatic cancer patients, serving as possible biomarkers. Recently, RNA interference-based loss-of-function screens have been used to identify functionally relevant genes, whose knock-down has impact on pancreatic cancer cell viability, thereby representing potential new targets for therapeutic intervention. This review summarizes recent results of transcriptional, proteomic and functional screens in pancreatic cancer and discusses potentials and limitations of the respective technologies as well as their impact on future therapeutic developments

Fine needle aspiration biopsy of pancreas. Cytological assessment

International Nuclear Information System (INIS)

Coufal, L.; Heger, L.

1987-01-01

The benefits are presented of cytological examination of bioptical material from the pancreas using computerized tomography (CT) or ultrasound. The case is presented of one patient who had repeatedly undergone endoscopy with no results. Only cytological examination of material sampled using fine needle aspiration under CT control helped to immediately diagnose the process. The cytological finding correlated with the histological examination of material later taken during surgery. The problems are discussed of the differential diagnosis of tumors of the pancreas. (author). 5 figs., 9 refs

Immunogenicity of Anti-HLA Antibodies in Pancreas and Islet Transplantation.

Science.gov (United States)

Chaigne, Benjamin; Geneugelijk, Kirsten; Bédat, Benoît; Ahmed, Mohamed Alibashe; Hönger, Gideon; De Seigneux, Sophie; Demuylder-Mischler, Sandrine; Berney, Thierry; Spierings, Eric; Ferrari-Lacraz, Sylvie; Villard, Jean

2016-11-01

The aim of the current study was to characterize the anti-HLA antibodies before and after pancreatic islet or pancreas transplantation. We assessed the risk of anti-donor-specific antibody (DSA) sensitization in a single-center, retrospective clinical study at Geneva University Hospital. Data regarding clinical characteristics, graft outcome, HLA mismatch, donor HLA immunogenicity, and anti-HLA antibody characteristics were collected. Between January 2008 and July 2014, 18 patients received islet transplants, and 26 patients received a pancreas transplant. Eleven out of 18 patients (61.1%) in the islet group and 12 out of 26 patients (46.2%) in the pancreas group had anti-HLA antibodies. Six patients (33.3%) developed DSAs against HLA of the islets, and 10 patients (38.4%) developed DSAs against HLA of the pancreas. Most of the DSAs were at a low level. Several parameters such as gender, number of times cells were transplanted, HLA mismatch, eplet mismatch and PIRCHE-II numbers, rejection, and infection were analyzed. Only the number of PIRCHE-II was associated with the development of anti-HLA class II de novo DSAs. Overall, the development of de novo DSAs did not influence graft survival as estimated by insulin independence. Our results indicated that pretransplant DSAs at low levels do not restrict islet or pancreas transplantation [especially islet transplantation (27.8% vs. 15.4.%)]. De novo DSAs do occur at a similar rate in both pancreas and islet transplant recipients (mainly of class II), and the immunogenicity of donor HLA is a parameter that should be taken into consideration. When combined with an immunosuppressive regimen and close follow-up, development of low levels of DSAs was not found to result in reduced graft survival or graft function in the current study.

PREVENTION AND TREATMENT OF REJECTION AFTER SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION

Institute of Scientific and Technical Information of China (English)

Lei Yang; Yong-feng Liu; Shu-rong Liu; Gang Wu; Jia-lin Zhang; Yi-man Meng; Shao-wei Shong; Gui-chen Li

2005-01-01

Objective To explore methods of preventing and reversing rejection after simultaneous pancreas-kidney (SPK) tran splantation. Methods Seventeen patients underwent SPK transplantation from September 1999 to September 2003 were reviewed retrospectively. Immunosuppression was achieved by a triple drug regimen consisting of cyclosporine, mycophenolate mofteil (MMF), and steroids. Three patients were treated with anti-CD3 monoclone antibody (OKT3, 5 mg· d-1) for induction therapy for a mean period of 5-7 days. One patients received IL-2 receptor antibodies (daclizumab) in a dose of 1 mg· kg-1 on the day of transplant and the 5th day posttransplant. One patient was treated with both OKT3 and daclizumab for induction. Results No primary non-functionality of either kidney or pancreas occurred in this series of transplantations. Function of all the kidney grafts recovered within 2 to 4 days after transplantation. The level of serum creatinine was 94 ± 11 μmol/L on the 7th day posttransplant. One patient experienced the accelerated rejection, resulting in the resection of the pancreas and kidney grafts because of the failure of conservative therapy. The incidence of the first rejection episodes at 3 months was 47.1% (8/17). Only the kidney was involved in 35.3% (6/17); and both the pancreas and kidney were involved in 11.8% (2/17). All these patients received a high-dose pulse of methylprednisone (0.5 g·d-1) for 3 days. OKT3 (0.5 mg·d-1) was administered for 7-10 days in two patients with both renal and pancreas rejection. All the grafts were successfully rescued. Conclusion Rejection, particularly acute rejection, is the major cause influencing graft function in SPK transplantation. Monitoring renal function and pancreas exocrine secretion, and reasonable application of immunosuppressants play important roles in the diagnosis and treatment of rejection.

Fibrosis of the pancreas: the initial tissue damage and the resulting pattern.

Science.gov (United States)

Klöppel, Günter; Detlefsen, Sönke; Feyerabend, Bernd

2004-07-01

Fibrosis in the pancreas is caused by such processes as necrosis/apoptosis, inflammation or duct obstruction. The initial event that induces fibrogenesis in the pancreas is an injury that may involve the interstitial mesenchymal cells, the duct cells and/or the acinar cells. Damage to any one of these tissue compartments of the pancreas is associated with cytokine-triggered transformation of resident fibroblasts/pancreatic stellate cells into myofibroblasts and the subsequent production and deposition of extracellular matrix. Depending on the site of injury in the pancreas and the involved tissue compartment, predominantly inter(peri)lobular fibrosis (as in alcoholic chronic pancreatitis), periductal fibrosis (as in hereditary pancreatitis), periductal and interlobular fibrosis (as in autoimmune pancreatitis) or diffuse inter- and intralobular fibrosis (as in obstructive chronic pancreatitis) develops.

/sup 75/Se-methionine uptake in the pancreas. An experimental investigation in mice

Energy Technology Data Exchange (ETDEWEB)

Lewander, R [Danderyds Sjukhus, Stockholm (Sweden)

1975-11-01

Measurements of the uptake of /sup 75/Se-methionine in the abdominal visceral organs of mice indicate that amino acids (Aminosol) significantly increase the accumulation of the isotope in pancreas. Similarly, a beneficial effect is observed on the distribution of activity between pancreas and blood, while withdrawal of food adversely affects the uptake in the pancreas and gastro-intestinal tract.

Transcriptional regulation of pancreas development and β-cell function [Review].

Science.gov (United States)

Fujitani, Yoshio

2017-05-30

A small number of cells in the adult pancreas are endocrine cells. They are arranged in clusters called islets of Langerhans. The islets make insulin, glucagon, and other endocrine hormones, and release them into the blood circulation. These hormones help control the level of blood glucose. Therefore, a dysfunction of endocrine cells in the pancreas results in impaired glucose homeostasis, or diabetes mellitus. The pancreas is an organ that originates from the evaginations of pancreatic progenitor cells in the epithelium of the foregut endoderm. Pancreas organogenesis and maturation of the islets of Langerhans occurs via a coordinated and complex interplay of transcriptional networks and signaling molecules, which guide a stepwise and repetitive process of the propagation of progenitor cells and their maturation, eventually resulting in a fully functional organ. Increasing our understanding of the extrinsic, as well as intrinsic mechanisms that control these processes should facilitate the efforts to generate surrogate β cells from ES or iPS cells, or to reactivate the function of important cell types within pancreatic islets that are lost in diabetes.

SU-C-BRB-02: Automatic Planning as a Potential Strategy for Dose Escalation for Pancreas SBRT?

International Nuclear Information System (INIS)

Wang, S; Zheng, D; Ma, R; Lin, C; Zhu, X; Lei, Y; Enke, C; Zhou, S

2016-01-01

Purpose: Stereotactic body radiation therapy (SBRT) has been suggested to provide high rates of local control for locally advanced pancreatic cancer. However, the close proximity of highly radiosensitive normal tissues usually causes the labor-intensive planning process, and may impede further escalation of the prescription dose. The present study evaluates the potential of an automatic planning system as a dose escalation strategy. Methods: Ten pancreatic cancer patients treated with SBRT were studied retrospectively. SBRT was delivered over 5 consecutive fractions with 6 ∼ 8Gy/fraction. Two plans were generated by Pinnacle Auto-Planning with the original prescription and escalated prescription, respectively. Escalated prescription adds 1 Gy/fraction to the original prescription. Manually-created planning volumes were excluded in the optimization goals in order to assess the planning efficiency and quality simultaneously. Critical organs with closest proximity were used to determine the plan normalization to ensure the OAR sparing. Dosimetric parameters including D100, and conformity index (CI) were assessed. Results: Auto-plans directly generate acceptable plans for 70% of the cases without necessity of further improvement, and two more iterations at most are necessary for the rest of the cases. For the pancreas SBRT plans with the original prescription, autoplans resulted in favorable target coverage and PTV conformity (D100 = 96.3% ± 1.48%; CI = 0.88 ± 0.06). For the plans with the escalated prescriptions, no significant target under-dosage was observed, and PTV conformity remains reasonable (D100 = 93.3% ± 3.8%, and CI = 0.84 ± 0.05). Conclusion: Automatic planning, without substantial human-intervention process, results in reasonable PTV coverage and PTV conformity on the premise of adequate OAR sparing for the pancreas SBRT plans with escalated prescription. The results highlight the potential of autoplanning as a dose escalation strategy for pancreas

SU-C-BRB-02: Automatic Planning as a Potential Strategy for Dose Escalation for Pancreas SBRT?

Energy Technology Data Exchange (ETDEWEB)

Wang, S; Zheng, D; Ma, R; Lin, C; Zhu, X; Lei, Y; Enke, C; Zhou, S [University of Nebraska Medical Center, Omaha, NE (United States)

2016-06-15

Purpose: Stereotactic body radiation therapy (SBRT) has been suggested to provide high rates of local control for locally advanced pancreatic cancer. However, the close proximity of highly radiosensitive normal tissues usually causes the labor-intensive planning process, and may impede further escalation of the prescription dose. The present study evaluates the potential of an automatic planning system as a dose escalation strategy. Methods: Ten pancreatic cancer patients treated with SBRT were studied retrospectively. SBRT was delivered over 5 consecutive fractions with 6 ∼ 8Gy/fraction. Two plans were generated by Pinnacle Auto-Planning with the original prescription and escalated prescription, respectively. Escalated prescription adds 1 Gy/fraction to the original prescription. Manually-created planning volumes were excluded in the optimization goals in order to assess the planning efficiency and quality simultaneously. Critical organs with closest proximity were used to determine the plan normalization to ensure the OAR sparing. Dosimetric parameters including D100, and conformity index (CI) were assessed. Results: Auto-plans directly generate acceptable plans for 70% of the cases without necessity of further improvement, and two more iterations at most are necessary for the rest of the cases. For the pancreas SBRT plans with the original prescription, autoplans resulted in favorable target coverage and PTV conformity (D100 = 96.3% ± 1.48%; CI = 0.88 ± 0.06). For the plans with the escalated prescriptions, no significant target under-dosage was observed, and PTV conformity remains reasonable (D100 = 93.3% ± 3.8%, and CI = 0.84 ± 0.05). Conclusion: Automatic planning, without substantial human-intervention process, results in reasonable PTV coverage and PTV conformity on the premise of adequate OAR sparing for the pancreas SBRT plans with escalated prescription. The results highlight the potential of autoplanning as a dose escalation strategy for pancreas

File list: His.Pan.20.AllAg.Pancreatic_cancer_cells [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available His.Pan.20.AllAg.Pancreatic_cancer_cells mm9 Histone Pancreas Pancreatic cancer cel...ls http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Pan.20.AllAg.Pancreatic_cancer_cells.bed ...

File list: His.Pan.10.AllAg.Pancreatic_cancer_cells [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available His.Pan.10.AllAg.Pancreatic_cancer_cells mm9 Histone Pancreas Pancreatic cancer cel...ls http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Pan.10.AllAg.Pancreatic_cancer_cells.bed ...

File list: Pol.Pan.50.AllAg.Pancreatic_cancer_cells [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available Pol.Pan.50.AllAg.Pancreatic_cancer_cells mm9 RNA polymerase Pancreas Pancreatic cancer... cells http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Pol.Pan.50.AllAg.Pancreatic_cancer_cells.bed ...

File list: His.Pan.50.AllAg.Pancreatic_cancer_cells [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available His.Pan.50.AllAg.Pancreatic_cancer_cells mm9 Histone Pancreas Pancreatic cancer cel...ls http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Pan.50.AllAg.Pancreatic_cancer_cells.bed ...

Retinol dehydrogenase-10 regulates pancreas organogenesis and endocrine cell differentiation via paracrine retinoic acid signalling

DEFF Research Database (Denmark)

Arregi, Igor; Climent, Maria; Iliev, Dobromir

2016-01-01

Vitamin A-derived retinoic acid (RA) signals are critical for the development of several organs, including the pancreas. However, the tissue-specific control of RA synthesis in organ and cell lineage development has only poorly been addressed in vivo. Here we show that Retinol dehydrogenase-10 (Rdh......10), a key enzyme in embryonic RA production, has important functions in pancreas organogenesis and endocrine cell differentiation. Rdh10 was expressed in the developing pancreas epithelium and surrounding mesenchyme. Rdh10 null mutant mouse embryos exhibited dorsal pancreas agenesis...... and a hypoplastic ventral pancreas with retarded tubulogenesis and branching. Conditional disruption of Rdh10 from the endoderm caused increased mortality, reduced body weight and lowered blood glucose levels after birth. Endodermal Rdh10 deficiency led to a smaller dorsal pancreas with a reduced density of early...

Cigarette smoke-induced differential expression of the genes involved in exocrine function of the rat pancreas.

Science.gov (United States)

Wittel, Uwe A; Singh, Ajay P; Henley, Brandon J; Andrianifahanana, Mahefatiana; Akhter, Mohammed P; Cullen, Diane M; Batra, Surinder K

2006-11-01

Little is known about the molecular and biological aspects of the epidemiological association between smoking and pancreatic pathology, such as chronic pancreatitis and pancreatic cancer. Recently, we reported that tobacco smoke exposure induced morphological alterations in the rat pancreas. Here, we have investigated the alterations in the expression of genes associated with exocrine pancreatic function and cellular differentiation upon exposure to cigarette smoke. Female rats were exposed to environmental smoke inhalation for 2 d/wk (70 min/d) for 12 weeks. The expression profiles of trypsinogen, pancreas-specific trypsin inhibitor, cholecystokinin A receptor, cystic fibrosis transmembrane conductance regulator (CFTR), carbonic anhydrase, and Muc1 and Muc4 mucins transcripts were analyzed by RNA slot blot analysis. Muc4 expression was also examined by immunohistochemistry. Our data revealed that the ratio of trypsinogen to that of the protective pancreas-specific trypsin inhibitor was elevated upon cigarette smoke exposure. The expression of carbonic anhydrase and CFTR remained unaltered when inflammatory signs were not detected in histological examinations. On the other hand, when pancreatic inflammation was present, the levels of CFTR and carbonic anhydrase were increased, indicating ductal and/or centroacinar cell involvement. No changes in the expression of Muc1 and Muc4 mucins were observed. Our data show that cigarette smoke exposure leads to an increased vulnerability to pancreatic self-digestion. Moreover, the concomitant involvement of pancreatic ducts occurs only when focal pancreatic inflammation is present.

A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum Markers

Directory of Open Access Journals (Sweden)

Manju D. Chandrasegaram

2013-01-01

Full Text Available Background. Autoimmune pancreatitis (AIP often mimics pancreatic cancer. The diagnosis of both conditions is difficult preoperatively let alone when they coexist. Several reports have been published describing pancreatic cancer in the setting of AIP. Case Report. The case of a 53-year-old man who presented with abdominal pain, jaundice, and radiological features of autoimmune pancreatitis, with a “sausage-shaped” pancreas and bulky pancreatic head with portal vein impingement, is presented. He had a normal serum IgG4 and only mildly elevated Ca-19.9. Initial endoscopic ultrasound-(EUS- guided fine-needle aspiration (FNA of the pancreas revealed an inflammatory sclerosing process only. A repeat EUS guided biopsy following biliary decompression demonstrated both malignancy and features of autoimmune pancreatitis. At laparotomy, a uniformly hard, bulky pancreas was found with no sonographically definable mass. A total pancreatectomy with portal vein resection and reconstruction was performed. Histology revealed adenosquamous carcinoma of the pancreatic head and autoimmune pancreatitis and squamous metaplasia in the remaining pancreas. Conclusion. This case highlights the diagnostic and management difficulties in a patient with pancreatic cancer in the setting of serum IgG4-negative, Type 2 AIP.

The effect of radiation on the function of the residual pancreas

International Nuclear Information System (INIS)

Matsuoka, Yoshisuke; Tsujii, Hirohiko; Kamada, Tadashi; Irie, Goro

1987-01-01

For patients with carcinomas of the bile duct and the pancreas, a pancreatoduodenectomy is generally the first choise of treatment. In our institute, the residual pancreas after surgery is transplanted into the abdominal wall in order to prevent diabetes mellites. We irradiated the residual pancreas postoperatively with a dosage of 15 to 43 Gy in order to inhibit the exocrine function. We then removed the drainage catheter from the residual pancreas. In the treatment, the endocrine function can be preserved. With respect to the radiation effect on the exocrine function, the amount of pancreatic secretion showed a transient increase in the first few days after the start of the irradiation, followed by a mild decrease. The serum amylase decreased immediatelly after the start of irradiation and increased sequentially during long-term observations. The amylase in the pancreatic juice showed a remarkable decrease immediatelly after the start of irradiation, and this decrease was maintained during long-term observations (The minimum level was observed from the dosage of 20 to 30 Gy). In order to analyse the radiation effect on the endocrine function, 50 g OGTTs were performed before and after irradiation in thirteen patients. In two of the thirteen patients, the results of the tests showed a new diabetic pattern after irradiation, which required insulin in one patient. It was concluded from our study that irradiation to the residual pancreas with in the dosage of 15 to 43 Gy the catheters in the residual pancreas could be removed in fourteen of fifteen patients without any unfavorable effect. (author)

Ultrasonography of the canine pancreas

Directory of Open Access Journals (Sweden)

Michelle L Avante

2018-01-01

Full Text Available This study describes the ultrasonographic techniques currently used in the evaluation of the canine pancreas. Ultrasonography was the first method to enable direct visualization of the pancreas in humans and it has been subsequently applied to animals. Currently, it is the method of choice for pancreatic evaluation and is essential as a diagnostic tool in the detection of abnormalities, especially tumors. Innovative equipment technology has led to the emergence of techniques complementary to B-mode ultrasound; such as Doppler, elastography, and contrast-enhanced ultrasonography, which have enabled more accurate diagnosis. Doppler provides information on vascular architecture and the hemodynamic aspect of blood vessels in multiple organs. ARFI elastography provides detailed images of the alterations detected by conventional examination (qualitative method and assists in differentiating between benign and malignant processes (quantitative method. Microbubble contrast agents determine parameters related to homogeneous and heterogeneous filling of organs with microbubbles, mainly nodular areas, thus defining high and low intensity patterns.

mTOR Inhibition and Clinical Transplantation: Pancreas and Islet.

Science.gov (United States)

Berney, Thierry; Andres, Axel; Toso, Christian; Majno, Pietro; Squifflet, Jean-Paul

2018-02-01

This brief overview discusses the beneficial and deleterious effects of mammalian target of rapamycin (mTOR) inhibitors on β cells, and how sirolimus- and everolimus-based immunosuppression have impacted on practices and outcomes of pancreas and islet transplantation. Sirolimus was the cornerstone of immunosuppressive regimens in islet transplantation at the turn of the millenium, but utilization of mTOR inhibitors has progressively decreased from greater than 80% to less than 50% of islet transplant recipients in more recent years. For whole pancreas transplantation, mTOR inhibitors were used in approximately 20% of patients in the early 2000s, but this dropped over the years to less than 10% currently. This decrease is arguably due to less well-tolerated side effects without the advantage of better outcomes. Nonetheless, mTOR inhibitors remain extremely valuable as second-line immunosuppressants in pancreas and islet transplantation.

File list: DNS.Pan.20.AllAg.Pancreatic_cancer_cells [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available DNS.Pan.20.AllAg.Pancreatic_cancer_cells mm9 DNase-seq Pancreas Pancreatic cancer c...ells http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/DNS.Pan.20.AllAg.Pancreatic_cancer_cells.bed ...

Circumportal Pancreas-a Must Know Pancreatic Anomaly for the Pancreatic Surgeon.

Science.gov (United States)

Luu, Andreas Minh; Braumann, C; Herzog, T; Janot, M; Uhl, W; Chromik, A M

2017-02-01

Circumportal pancreas is a rare congenital pancreatic anomaly with encasement of the portal vein and/or the superior mesenteric vein by pancreatic tissue. It is often overlooked on cross-sectional imaging studies and can be encountered during pancreatic surgery. Pancreatic head resection with circumportal pancreas is technically difficult and bears an increased risk of postoperative pancreatic fistula. A retrospective chart review of our data base for all patients who had undergone pancreatic head resection between 2004 and 2015 was performed. We identified six patients out of 1102 patients who had undergone pancreatic head surgery in the study period. CT-scan and MRI were never able to identify circumportal pancreas prior to surgery. The right hepatic an artery derived from the superior mesenteric artery in four cases (67%). Additional resection of the pancreatic body was always performed. Postoperative course was uneventful in all cases without occurrence of pancreatic fistula. Circumportal pancreas is a rare entity every pancreatic surgeon should be aware of. It is difficult to identify on cross-sectional imaging studies. A right hepatic artery arising from the superior mesenteric artery should raise suspicion of circumportal pancreas. Additional pancreatic tissue resection should be performed during pancreatic head resections to avoid pancreatic fistula.

Inflammation increases cells expressing ZSCAN4 and progenitor cell markers in the adult pancreas

Science.gov (United States)

Azuma, Sakiko; Yokoyama, Yukihiro; Yamamoto, Akiko; Kyokane, Kazuhiro; Niida, Shumpei; Ishiguro, Hiroshi; Ko, Minoru S. H.

2013-01-01

We have recently identified the zinc finger and SCAN domain containing 4 (Zscan4), which is transiently expressed and regulates telomere elongation and genome stability in mouse embryonic stem (ES) cells. The aim of this study was to examine the expression of ZSCAN4 in the adult pancreas and elucidate the role of ZSCAN4 in tissue inflammation and subsequent regeneration. The expression of ZSCAN4 and other progenitor or differentiated cell markers in the human pancreas was immunohistochemically examined. Pancreas sections of alcoholic or autoimmune pancreatitis patients before and under maintenance corticosteroid treatment were used in this study. In the adult human pancreas a small number of ZSCAN4-positive (ZSCAN4+) cells are present among cells located in the islets of Langerhans, acini, ducts, and oval-shaped cells. These cells not only express differentiated cell markers for each compartment of the pancreas but also express other tissue stem/progenitor cell markers. Furthermore, the number of ZSCAN4+ cells dramatically increased in patients with chronic pancreatitis, especially in the pancreatic tissues of autoimmune pancreatitis actively regenerating under corticosteroid treatment. Interestingly, a number of ZSCAN4+ cells in the pancreas of autoimmune pancreatitis returned to the basal level after 1 yr of maintenance corticosteroid treatment. In conclusion, coexpression of progenitor cell markers and differentiated cell markers with ZSCAN4 in each compartment of the pancreas may indicate the presence of facultative progenitors for both exocrine and endocrine cells in the adult pancreas. PMID:23599043

Annular pancreas causing extrahepatic biliary obstruction

International Nuclear Information System (INIS)

Ogulin, M.; Jamar, B.

2004-01-01

Background. Annular pancreas is an uncommon congenital abnormality, consisting of a flat band of pancreatic tissue, which encircles duodenum or extrahepatic biliary duct. We present a case of obstructive jaundice, caused by annular pancreas. Case report. A 46 years old female was admitted because of a sudden onset of abdominal pain, vomiting and jaundice. For the last six years she occasionally noticed her skin was light yellow, in the last year she felt distension in the upper abdomen, especially after fatty meals. Conclusions. Two US examinations, the first one six months before the admission, showed dilated hepatic ducts. The reason of dilatation was unclear, even after the endoscopic US examination. At operation an almost complete obstruction of the common hepatic duct was found, caused by a narrow band of pancreatic tissue. (author)

Atypical E2f functions are critical for pancreas polyploidization.

Science.gov (United States)

Matondo, Ramadhan B; Moreno, Eva; Toussaint, Mathilda J M; Tooten, Peter C J; van Essen, Saskia C; van Liere, Elsbeth A; Youssef, Sameh A; Bongiovanni, Laura; de Bruin, Alain

2018-01-01

The presence of polyploid cells in the endocrine and exocrine pancreas has been reported for four decades. In rodents, pancreatic polyploidization is initiated after weaning and the number of polyploid cells increases with age. Surprisingly the molecular regulators and biological functions of polyploidization in the pancreas are still unknown. We discovered that atypical E2f activity is essential for polyploidization in the pancreas, using an inducible Cre/LoxP approach in new-born mice to delete ubiquitously the atypical E2f transcription factors, E2f7 and E2f8. In contrast to its critical role in embryonic survival, conditional deletion of both of both atypical E2fs in newborn mice had no impact on postnatal survival and mice lived until old age. However, deficiency of E2f7 or E2f8 alone was sufficient to suppress polyploidization in the pancreas and associated with only a minor decrease in blood serum levels of glucose, insulin, amylase and lipase under 4 hours starvation condition compared to wildtype littermates. In mice with fewer pancreatic polyploid cells that were fed ad libitum, no major impact on hormones or enzymes levels was observed. In summary, we identified atypical E2fs to be essential for polyploidization in the pancreas and discovered that postnatal induced loss of both atypical E2fs in many organs is compatible with life until old age.

Atypical E2f functions are critical for pancreas polyploidization.

Directory of Open Access Journals (Sweden)

Ramadhan B Matondo

Full Text Available The presence of polyploid cells in the endocrine and exocrine pancreas has been reported for four decades. In rodents, pancreatic polyploidization is initiated after weaning and the number of polyploid cells increases with age. Surprisingly the molecular regulators and biological functions of polyploidization in the pancreas are still unknown. We discovered that atypical E2f activity is essential for polyploidization in the pancreas, using an inducible Cre/LoxP approach in new-born mice to delete ubiquitously the atypical E2f transcription factors, E2f7 and E2f8. In contrast to its critical role in embryonic survival, conditional deletion of both of both atypical E2fs in newborn mice had no impact on postnatal survival and mice lived until old age. However, deficiency of E2f7 or E2f8 alone was sufficient to suppress polyploidization in the pancreas and associated with only a minor decrease in blood serum levels of glucose, insulin, amylase and lipase under 4 hours starvation condition compared to wildtype littermates. In mice with fewer pancreatic polyploid cells that were fed ad libitum, no major impact on hormones or enzymes levels was observed. In summary, we identified atypical E2fs to be essential for polyploidization in the pancreas and discovered that postnatal induced loss of both atypical E2fs in many organs is compatible with life until old age.

Mature cystic teratoma of the pancreas in a child

International Nuclear Information System (INIS)

Yu, C.W.; Liu, K.L.; Li, Y.W.; Lin, W.C.

2003-01-01

A cystic pancreatic tumour is rare in a child and a mature cystic teratoma of the pancreas is even rarer. This is the first demonstration of the CT appearance of such a tumour in a child. We present a 2-year-old boy who presented with a palpable abdominal mass. Abdominal CT revealed a huge cystic mass in the upper abdomen. Pathology disclosed a mature cystic teratoma originating from the pancreas. (orig.)

The role of 3-D imaging and computer-based postprocessing for surgery of the liver and pancreas

International Nuclear Information System (INIS)

Grenacher, L.; Kauffmann, G.W.; Richter, G.M.; Thorn, M.; Vetter, M.; Hassenpflug, P.; Meinzer, H.P.; Knaebel, H.P.; Kraus, T.; Buechler, M.W.

2005-01-01

Cross-sectional imaging based on navigation and virtual reality planning tools are well-established in the surgical routine in orthopedic surgery and neurosurgery. In various procedures, they have achieved a significant clinical relevance and efficacy and have enhanced the discipline's resection capabilities. In abdominal surgery, however, these tools have gained little attraction so far. Even with the advantage of fast and high resolution cross-sectional liver and pancreas imaging, it remains unclear whether 3D planning and interactive planning tools might increase precision and safety of liver and pancreas surgery. The inability to simply transfer the methodology from orthopedic or neurosurgery is mainly a result of intraoperative organ movements and shifting and corresponding technical difficulties in the on-line applicability of presurgical cross sectional imaging data. For the interactive planning of liver surgery, three systems partly exist in daily routine: HepaVision2 (MeVis GmbH, Bremen), LiverLive (Navidez Ltd. Slovenia) and OrgaNicer (German Cancer Research Center, Heidelberg). All these systems have realized a half- or full-automatic liver-segmentation procedure to visualize liver segments, vessel trees, resected volumes or critical residual organ volumes, either for preoperative planning or intraoperative visualization. Acquisition of data is mainly based on computed tomography. Three-dimensional navigation for intraoperative surgical guidance with ultrasound is part of the clinical testing. There are only few reports about the transfer of the visualization of the pancreas, probably caused by the difficulties with the segmentation routine due to inflammation or organ-exceeding tumor growth. With this paper, we like to evaluate and demonstrate the present status of software planning tools and pathways for future pre- and intraoperative resection planning in liver and pancreas surgery. (orig.)

Unions, Vitamins, Exercise: Unionized Graduate Students

Science.gov (United States)

Dewberry, David R.

2005-01-01

After the turbulent labor history of America in the early to mid twentieth century, there has been a general decline of unions. Nevertheless, many graduate school teaching assistants are unionizing in attempts to gain better pay and benefits and remove themselves from an "Ivory Sweatshop." This article discusses a history of unions…

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

Science.gov (United States)

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

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

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

Science.gov (United States)

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

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

Laparoscopic versus open distal pancreatectomy for pancreatic cancer

NARCIS (Netherlands)

Riviere, D.M.; Gurusamy, K.S.; Kooby, D.A.; Vollmer, C.M.; Besselink, M.G.; Davidson, B.R.; Laarhoven, C.J.H.M. van

2016-01-01

BACKGROUND: Surgical resection is currently the only treatment with the potential for long-term survival and cure of pancreatic cancer. Surgical resection is provided as distal pancreatectomy for cancers of the body and tail of the pancreas. It can be performed by laparoscopic or open surgery. In

New insights into pancreatic cancer biology.

Science.gov (United States)

Hidalgo, M

2012-09-01

Pancreatic cancer remains a devastating disease. Over the last few years, there have been important advances in the molecular and biological understanding of pancreatic cancer. This included understanding of the genomic complexity of the disease, the role of pancreatic cancer stem cells, the relevance of the tumor microenvironment, and the unique metabolic adaptation of pancreas cancer cells to obtain nutrients under hypoxic environment. In this paper, we review the most salient developments in these few areas.

CT of the pancreas with a fat-density oral contrast medium

International Nuclear Information System (INIS)

Raptopoulos, V.; Davidoff, A.; Davis, M.A.; Coolbaugh, B.L.; Smith, E.H.

1987-01-01

Visualization of the head of the pancreas on CT was evaluated in three groups, each consisting of 100 patients without pancreatic pathology who received a fat-density oral preparation. The corn oil emulsion was tolerated well by the patients and allowed consistently superior discrimination of the head of the pancreas from the duodenal C-loop as compared to the other two control groups. A score was developed for the CT discrimination of duodenum from pancreas. The average score for corn oil emulsion was .94, as opposed to .74 for the high-density agents and .76 for patients who did not receive any oral preparation. Until further experience is acquired, the authors do not recommend the use of corn oil in patients thought to have pancreatic pseudocysts or abscesses. In addition, the use of fat-containing oral agents may be contraindicated in patients with acute pancreatitis. For routine CT evaluation of the pancreas and upper abdomen, the authors consider corn oil emulsion superior to the other oral regimens

Pancreas transplantation

International Nuclear Information System (INIS)

Snider, J.F.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Letourneau, J.G.

1989-01-01

Pancreas transplantation can be complicated by vascular thrombosis, stenosis, or anastomotic leak, complications that predispose to transplant pancreatectomy. The relative roles of noninvasive radiologic studies in such vascular complications have been correlated with angiographic or pathologic data. The results of 54 scintigraphic studies, 25 CT studies, 16 sonograms, and 23 color Doppler examinations have been correlated with those of 40 angiograms and 28 pathologic studies in a population of 185 recipients. CT (sensitivity, 100%; specificity, 75%; accuracy, 92%) and US (sensitivity, 88%; specificity, 80%; accuracy, 85%) were most helpful in noninvasive screening for vascular complications, while angiography remains nearly definite in the radiographic diagnosis of these problems

Stages of Pancreatic Cancer

Science.gov (United States)

... overweight. Having a personal history of diabetes or chronic pancreatitis . Having a family history of pancreatic cancer or ... have not started treatment. Five types of standard treatment are used: Surgery ... Whipple procedure : A surgical procedure in which the head of the pancreas , ...

Intrahepatic peribiliary perivascular epithelioid cell tumor (PEComa) associated with heterotopic pancreas: A case report.

Science.gov (United States)

Kiriyama, Yuka; Tsukamoto, Tetsuya; Mizoguchi, Yoshikazu; Ishihara, Shin; Horiguchi, Akihiko; Tokoro, Takamasa; Kato, Yutaro; Sugioka, Atsushi; Kuroda, Makoto

2016-08-20

Perivascular epithelioid-cell tumor (PEComa) is a group of rare mesenchymal neoplasms that express myomelanocytic-cell markers and exhibit a wide variety of histopathological features. Although heterotopic pancreas has been reported to occur in the gastrointestinal tract, intrahepatic heterotopic pancreas has been reported only rarely. We present a case of intrahepatic PEComa that showed a strong regional correlation with the presence of heterotopic pancreas. An intrahepatic tumor and biliary dilatation was incidentally discovered during a diagnostic evaluation to investigate low-back pain in a 47-year-old Japanese male. Cholangiocarcinoma was suspected and a left hemihepatectomy performed. Histological examination revealed a 3 × 3.8-mm tumor in the neighboring B2 bile duct. Histological and immunohistochemical investigations revealed the presence of a PEComa and pancreatic acini within the tumor mass. PEComa in the hepatobiliary and pancreatic regions are extremely rare. The presence of heterotopic pancreas is also relatively uncommon. The strong regional association of these 2 lesions raises the possibility of a PEComa originating from heterotopic pancreas or from an irritable response caused by heterotopic pancreas.

Epithermal neutron beam adoption for lung and pancreatic cancer treatment by boron neutron capture therapy

International Nuclear Information System (INIS)

Matsumoto, Tetsuo; Fukushima, Yuji

2001-01-01

The depth-dose distributions were evaluated for possible treatment of both lung and pancreatic cancers using an epithermal neutron beam. The Monte Carlo Neutron Photon (MCNP) calculations showed that physical dose in tumors were 6 and 7 Gy/h, respectively, for lung and pancreas, attaining an epithermal neutron flux of 5 x 10 8 ncm -2 s -1 . The boron concentrations were assumed at 100 ppm and 30 ppm, respectively, for lung and pancreas tumors and normal tissues contains 1/10 tumor concentrations. The dose ratios of tumor to normal tissue were 2.5 and 2.4, respectively, for lung and pancreas. The dose evaluation suggests that BNCT using an epithermal neutron beam could be applied for both lung and pancreatic cancer treatment. (author)

Trade union revitalisation

DEFF Research Database (Denmark)

Ibsen, Christian Lyhne; Tapia, Maite

2017-01-01

In this article, we review and assess research on the role of trade unions in labour markets and society, the current decline of unions and union revitalisation. The review shows three main trends. First, trade unions are converging into similar strategies of revitalisation. The ‘organising model...... their traditional strongholds of collective bargaining and corporatist policy-making. Second, research has shown that used strategies are not a panacea for success for unions in countries that pearheaded revitalisation. This finding points to the importance of supportive institutional frameworks if unions...... in adverse institutional contexts, can be effective when they reinvent their repertoires of contention, through political action or campaigning along global value chains....

The value of computer tomography and sonography in the investigation of the pancreas

International Nuclear Information System (INIS)

Lackner, K.; Frommhold, H.; Grauthoff, H.; Moedder, U.; Heuser, L.; Braun, G.; Buurman, R.; Scherer, K.; Hamburg Univ.; Koeln Univ.

1980-01-01

Three hundred and five patients were examined by computer tomography and sonography. In 117 patients no abnormalities were found in the pancreas. The accuracy of computer tomography was 87%, of sonography 85%. In 41 patients the presence of a carcinoma of the pancreas was confirmed histologically. In this group the sensitivity of computer tomography was 83%, of sonography 85%. Thirty-four patients suffered from acute pancreatitis. In this group sensitivity of the two methods was equal at 79%. 113 patients had changes of chronic pancreatitis. Sensitivity of computer tomography was 84%, of sonography 70%. Computer tomography is better at demonstrating calcification in the pancreas. Atrophy of the pancreas cannot be diagnosed by sonography. (orig.) [de

Pancreas volume and fat fraction in children with Type 1 diabetes.

Science.gov (United States)

Regnell, S E; Peterson, P; Trinh, L; Broberg, P; Leander, P; Lernmark, Å; Månsson, S; Elding Larsson, H

2016-10-01

People with Type 1 diabetes have smaller pancreases than healthy individuals. Several diseases causing pancreatic atrophy are associated with pancreatic steatosis, but pancreatic fat in Type 1 diabetes has not been measured. This cross-sectional study aimed to compare pancreas size and fat fraction in children with Type 1 diabetes and controls. The volume and fat fraction of the pancreases of 22 children with Type 1 diabetes and 29 controls were determined using magnetic resonance imaging. Pancreas volume was 27% smaller in children with diabetes (median 34.9 cm(3) ) than in controls (47.8 cm(3) ; P Pancreas volume correlated positively with age in controls (P = 0.033), but not in children with diabetes (P = 0.649). Pancreas volume did not correlate with diabetes duration, but it did correlate positively with units of insulin/kg body weight/day (P = 0.048). A linear model of pancreas volume as influenced by age, body surface area and insulin units/kg body weight/day found that insulin dosage correlated with pancreas volume after controlling for both age and body surface area (P = 0.009). Pancreatic fat fraction was not significantly different between the two groups (1.34% vs. 1.57%; P = 0.891). Our findings do not indicate that pancreatic atrophy in Type 1 diabetes is associated with an increased pancreatic fat fraction, unlike some other diseases featuring reduced pancreatic volume. We speculate that our results may support the hypotheses that much of pancreatic atrophy in Type 1 diabetes occurs before the clinical onset of the disease and that exogenous insulin administration decelerates pancreatic atrophy after diabetes onset. © 2016 Diabetes UK.

Deep convolutional networks for pancreas segmentation in CT imaging

Science.gov (United States)

Roth, Holger R.; Farag, Amal; Lu, Le; Turkbey, Evrim B.; Summers, Ronald M.

2015-03-01

Automatic organ segmentation is an important prerequisite for many computer-aided diagnosis systems. The high anatomical variability of organs in the abdomen, such as the pancreas, prevents many segmentation methods from achieving high accuracies when compared to state-of-the-art segmentation of organs like the liver, heart or kidneys. Recently, the availability of large annotated training sets and the accessibility of affordable parallel computing resources via GPUs have made it feasible for "deep learning" methods such as convolutional networks (ConvNets) to succeed in image classification tasks. These methods have the advantage that used classification features are trained directly from the imaging data. We present a fully-automated bottom-up method for pancreas segmentation in computed tomography (CT) images of the abdomen. The method is based on hierarchical coarse-to-fine classification of local image regions (superpixels). Superpixels are extracted from the abdominal region using Simple Linear Iterative Clustering (SLIC). An initial probability response map is generated, using patch-level confidences and a two-level cascade of random forest classifiers, from which superpixel regions with probabilities larger 0.5 are retained. These retained superpixels serve as a highly sensitive initial input of the pancreas and its surroundings to a ConvNet that samples a bounding box around each superpixel at different scales (and random non-rigid deformations at training time) in order to assign a more distinct probability of each superpixel region being pancreas or not. We evaluate our method on CT images of 82 patients (60 for training, 2 for validation, and 20 for testing). Using ConvNets we achieve maximum Dice scores of an average 68% +/- 10% (range, 43-80%) in testing. This shows promise for accurate pancreas segmentation, using a deep learning approach and compares favorably to state-of-the-art methods.

Planimetric correlation between the submandibular glands and the pancreas: a postmortem ductographic study.

Science.gov (United States)

Stimec, Bojan V; Rakocevic, Zoran; Ignjatovic, Dejan; Fasel, Jean H D

2018-01-01

The salivary glands and pancreas have comparable anatomic and antigenic properties and can share common pathogenetic mechanisms involving toxic or autoimmune processes. The aim of this study is to assess the correlation in size between the normal submandibular glands and the pancreas. The study was based on human autopsy specimens of the pancreas, neck and oral base from 22 adults, both sexes (mean age, 57.9 years). The pancreatic and submandibular ducts were injected with a contrast medium, and the area of the salivary and pancreatic glandular ductograms was measured with the aid of software for quantification of visual information. Samples of tissue from the salivary glands and the pancreas were studied by means of light microscopy. A high correlation was found between the planimetric size of the pancreas and the submandibular glands (correlation coefficient 0.497 and 0.699 for the right and the left gland, respectively). This ratio was close to 5:1. There were no significant differences in size for the left vs. right submandibular gland (p = 0.39). The ductograms were significantly larger in size in males than in females (p pancreas, a result that is expected to have possible clinical implications in the long-term follow-up of patients with chronic pancreatitis.

Defining kidney allograft benefit from successful pancreas transplant: separating fact from fiction.

Science.gov (United States)

Wiseman, Alexander C; Stites, Erik; Kennealey, Peter

2018-06-06

To define the natural history of kidney allograft loss related to recurrent diabetes following transplant, and to understand the potential benefit of pancreas transplantation upon kidney allograft survival. A postulated benefit of simultaneous pancreas kidney transplant is that, unlike kidney transplant alone, euglycemia from the added pancreas allograft may confer a nephroprotective benefit and prevent recurrent diabetic nephropathy in the renal allograft. Recent large database analyses and long-term histological assessments have been published that assist in quantifying the problem of recurrent diabetic nephropathy and answering the question of the potential benefits of euglycemia. Further data may be extrapolated from larger single-center series that follow the prognosis of early posttransplant diabetes mellitus as another barometer of risk from diabetic nephropathy and graft loss. Recurrent diabetic nephropathy following kidney transplant is a relatively rare, late occurrence and its clinical significance is significantly diminished by the competing risks of death and chronic alloimmune injury. Although there are hints of a protective effect upon kidney graft survival with pancreas transplant, these improvements are small and may take decades to appreciate. Clinical decision-making regarding pancreas transplant solely based upon nephroprotective effects of the kidney allograft should be avoided.

Laparoscopic versus open distal pancreatectomy for pancreatic cancer

NARCIS (Netherlands)

Riviere, Deniece; Gurusamy, Kurinchi Selvan; Kooby, David A.; Vollmer, Charles M.; Besselink, Marc G. H.; Davidson, Brian R.; van Laarhoven, Cornelis J. H. M.

2016-01-01

Surgical resection is currently the only treatment with the potential for long-term survival and cure of pancreatic cancer. Surgical resection is provided as distal pancreatectomy for cancers of the body and tail of the pancreas. It can be performed by laparoscopic or open surgery. In operations on

Solid pseudopapillary pancreas tumors. Often neglected

International Nuclear Information System (INIS)

Herrmann, K.A.; Reiser, M.F.; Zech, C.J.; Helmberger, T.; Bruns, C.

2008-01-01

Solid pseudopapillary tumors of the pancreas (SPTP) are rare tumors of the pancreas with low malignancy potential and a very good prognostic outcome after surgery. They typically occur in young women or adolescents and consist of solid, cystic and cystic-hemorrhagic components. Imaging findings in these tumors are characteristic and include a fibrotic capsule with a clear delineation and exhibit solid and cystic-hemorrhagic signal and density characteristics. Calcifications may be present in the periphery of the tumor. The tumor capsule shows contrast enhancement, the solid components in the periphery enhance in the early phase and gradually and inhomogeneously in late phases. MRI is superior to CT and other imaging modalities for characterization of SPTP. Awareness and knowledge of this tumor entity with an excellent prognosis is crucial to guide the patient towards effective, predominantly organ-sparing surgical treatment. (orig.) [de

Pancreas Scanning with Se{sup 75}-Selenomethionine; Scintigraphie du Pancreas avec de la Selenomethionine Marquee au Selenium-75; Skennirovanie podzheludochnoj zhelezy s pomoshch'yu selenometionina, mechennogo Selenom-75; Exploracion del Pancreas con Selenometionina-{sup 75}Se

Energy Technology Data Exchange (ETDEWEB)

Blau, M. [Department of Nuclear Medicine, Roswell Park Memorial Institute, Buffalo, NY (United States)

1964-10-15

Amino-acids show a high degree of localization in the pancreas during the first few hours after administration. This specificity is related to the rapid synthesis and turnover of the digestive enzymes. Since none of the elements in the structure of amino-acids (C,H, N,0 and S) have suitable gamma-emitting isotopes, they cannot be used for scanning. Several I{sup 131} derivatives of amino-acids were prepared and tested, but the pancreas-localizing property of the original amino-acid was lost in every case. The chemical similarity of selenium and sulphur suggested that the selenium analogue of methionine might resemble methionine closely enough to take its place in protein synthesis. Se{sup 75} (halflife, 128 d; principal gamma-ray, 0.27 MeV) is suitable for scanning. Selenium-75-selenomethionine was prepared by yeast biosynthesis. The yeast was grown on a low sulphur medium containing high specific activity Se{sup 75} as selenite. After extraction with ether and hot trichloracetic acid, the protein residue was hydrolysed with hydrochloric acid The resulting amino-acid mixture was separated by column chromatography. Selenium-75-selenomethionine prepared in this manner showed biological properties of a natural aminoacid. The uptake in pancreas was about 7% of the administered dose and the concentration in a gramme of pancreas was seven times that in a gramme of liver. Blood and other organs had even lower uptakes. The clinical usefulness of pancreas scanning is now being evaluated. Tumours of the pancreas have been found as areas of decreased uptake. There is no concentration of selenomethionine in cases of acute pancreatitis. It is too early to give a statistical estimate of our ability to find tumours of the pancreas by this technique. The estimated total body dose from this procedure is less than 1 rad. The selenium dose is only a. few microgrammes and represents no toxicity hazard. (author) [Spanish] Los aminoacidos tienden a localizarse en el pancreas durante las

Poorly differentiated ductal adenocarcinoma of the pancreas with rapid progression in a young man.

Science.gov (United States)

Tezuka, Koji; Ishiyama, Tomoharu; Takeshita, Akiko; Matsumoto, Hidekazu; Jingu, Akira; Kikuchi, Jiro; Yamaya, Hideyuki; Ohe, Rintaro; Ishizawa, Tetsuya

2018-04-16

Pancreatic cancer in young adults is very rare. We report a case of young-onset poorly differentiated pancreatic ductal adenocarcinoma with rapid progression and poor prognosis in a 31-year-old Japanese man with no obvious family history of malignancy. Preoperative examinations revealed a mass lesion in the body of the pancreas, accompanied by a slightly dilated main pancreatic duct distal to the mass lesion. Pancreatic cancer with acute pancreatitis was suspected because of an elevation of serum pancreatic enzyme and tumor marker, along with imaging findings. Distal pancreatectomy with resection of the common hepatic artery and splenectomy along with lymph node dissection was performed. Microscopically, the tumor was mainly composed of poorly differentiated ductal adenocarcinoma. The postoperative course was uneventful, but the patient had multiple liver metastases 2 months postoperatively, in spite of adjuvant chemotherapy, and died 8 months postoperatively. This case may represent a rare instance of young-onset poorly differentiated ductal adenocarcinoma with rapid progression and may indicate potential risk factors of pancreatic cancer in young adults.

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Lifescience Database Archive (English)

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Lifescience Database Archive (English)

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Lifescience Database Archive (English)

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Lifescience Database Archive (English)

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File list: ALL.Pan.50.AllAg.Pancreatic_cancer_cells [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available ALL.Pan.50.AllAg.Pancreatic_cancer_cells mm9 All antigens Pancreas Pancreatic cancer... cells SRX174585,SRX174586,SRX174587 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Pan.50.AllAg.Pancreatic_cancer_cells.bed ...

A pancreas-preserving technique for the management of symptomatic pancreatic anastomotic insufficiency refractory to conservative treatment after pancreas head resection.

Science.gov (United States)

Königsrainer, Ingmar; Zieker, Derek; Beckert, Stefan; Glatzle, Jörg; Schroeder, Torsten H; Heininger, Alexandra; Nadalin, Silvio; Königsrainer, Alfred

2010-08-01

Management of symptomatic pancreatic anastomotic insufficiency after pancreas head resection remains controversial. Completion pancreatectomy as one frequently performed option is associated with poor prognosis. During a 4-year period, a two-step strategy was applied in four consecutive patients suffering from pancreatic anastomotic insufficiency refractory to conservative management after a pancreas head resection. In the first step, sepsis was overbridged by meticulous debridement and resection of the pancreaticojejunostomy, leaving the biliary anastomosis untouched, and selective drainage of the pancreatic duct as well as the peripancreatic area. In the second step, after recovery, the procedure was completed with a novel pancreaticojejunostomy. The surgical procedure was completed in three patients after a mean of 164 (range: 112-213) days. One patient died from cardiac arrest 54 days after the reoperation with resolved abdominal sepsis. No pancreatic anastomotic insufficiency occurred after the new pancreaticojejunostomy had been performed. Three patients are alive and tumor-free with normal exocrine and endocrine pancreatic function after a mean follow-up of 20.3 (3-38) months following the definitive reconstruction. The two-step pancreas-preserving strategy can be used as an alternative to completion pancreatectomy for patients suffering from severe pancreatic anastomotic insufficiency.

Histopathological effects of doxorubicin on pancreas in male albino rats

Directory of Open Access Journals (Sweden)

I.A. Ali

2015-06-01

Full Text Available The aim of this study was to investigate the histopathological side effects of doxorubicin on pancreas tissue in male albino rats Rattus norvegicus. This study were used 55 adult rats (2.5-3.5 month of age. The rats divided into two groups, the first group include (35 rats. The second group were (20 rats. Microscopial examination of pancreas lesion demonstrated oedema around the acini, swelling of the epithelial cells of acini, occurance of cystic fibrosis (mucoviscidosis at the concentration of (4,5 mg/kg of body weight ,occurrence of small islets that form of few cells and exocrine-endocrine transformation. There were thickness in the walls of blood vessels, thrombus, congestion of blood vessels, we conclude, that doxorubicin had histopathological effect on pancreas in sub-acute doses more than chronic doses.

Central control of glucose homeostasis: the brain--endocrine pancreas axis.

Science.gov (United States)

Thorens, B

2010-10-01

A large body of data gathered over the last decades has delineated the neuronal pathways that link the central nervous system with the autonomic innervation of the endocrine pancreas, which controls alpha- and beta-cell secretion activity and mass. These are important regulatory functions that are certainly keys for preserving the capacity of the endocrine pancreas to control glucose homeostasis over a lifetime. Identifying the cells involved in controlling the autonomic innervation of the endocrine pancreas, in response to nutrient, hormonal and environmental cues and how these cues are detected to activate neuronal activity are important goals of current research. Elucidation of these questions may possibly lead to new means for preserving or restoring defects in insulin and glucagon secretion associated with type 2 diabetes. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Pancreas and gallbladder agenesis in a newborn with semilobar holoprosencephaly, a case report.

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Hilbrands, Robert; Keymolen, Kathelijn; Michotte, Alex; Marichal, Miriam; Cools, Filip; Goossens, Anieta; Veld, Peter In't; De Schepper, Jean; Hattersley, Andrew; Heimberg, Harry

2017-05-19

Pancreatic agenesis is an extremely rare cause of neonatal diabetes mellitus and has enabled the discovery of several key transcription factors essential for normal pancreas and beta cell development. We report a case of a Caucasian female with complete pancreatic agenesis occurring together with semilobar holoprosencephaly (HPE), a more common brain developmental disorder. Clinical findings were later confirmed by autopsy, which also identified agenesis of the gallbladder. Although the sequences of a selected set of genes related to pancreas agenesis or HPE were wild-type, the patient's phenotype suggests a genetic defect that emerges early in embryonic development of brain, gallbladder and pancreas. Developmental defects of the pancreas and brain can occur together. Identifying the genetic defect may identify a novel key regulator in beta cell development.

File list: InP.Pan.05.AllAg.Pancreatic_cancer_cells [Chip-atlas[Archive

Lifescience Database Archive (English)

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Altered volume, morphology and composition of the pancreas in type 2 diabetes.

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Mavin Macauley

Full Text Available Although impairment in pancreatic insulin secretion is known to precede the clinical diagnosis of type 2 diabetes by up to a decade, fasting blood glucose concentration only rises abnormally once the impairment reaches a critical threshold. Despite its centrality to the pathogenesis of type 2 diabetes, the pancreas is the least studied organ due to its inaccessible anatomical position. Previous ultrasound and CT studies have suggested a possible decrease in pancreatic volume in type 2 diabetes. However, ultrasound techniques are relatively insensitive while CT uses ionizing radiation, making these modalities unsuitable for precise, longitudinal studies designed to explore the underlying mechanisms of type 2 diabetes. Hence there is a need to develop a non-invasive, safe and precise method to quantitate pancreas volume.We developed and applied magnetic resonance imaging at 3.0T to obtain balanced turbo field echo (BTFE structural images of the pancreas, together with 3-point Dixon images to quantify pancreatic triglyceride content. Pancreas volume, morphology and triglyceride content was quantified in a group of 41 subjects with well-controlled type 2 diabetes (HbA1c ≤ 7.6% taking only metformin (duration of T2DM 5.7 ± 0.7 years, and a control group of 14 normal glucose tolerance subjects matched for age, weight and sex.The mean pancreatic volume was found to be 33% less in type 2 diabetes than in normal glucose tolerant subjects (55.5 ± 2.8 vs. 82.6 ± 4.8 cm3; p < 0.0001. Pancreas volume was positively correlated with HOMA-β in the type 2 diabetes subjects (r = 0.31; p = 0.03 and controls (r = 0.46; p = 0.05 considered separately; and in the whole population studied (r = 0.37; p = 0.003. In type 2 diabetes, the pancreas was typically involuted with a serrated border. Pancreatic triglyceride content was 23% greater (5.4 ± 0.3 vs. 4.4 ± 0.4%; p = 0.02 in the type 2 diabetes group.This study describes for the first time gross abnormalities

Altered Volume, Morphology and Composition of the Pancreas in Type 2 Diabetes

Science.gov (United States)

Macauley, Mavin; Percival, Katie; Thelwall, Peter E.; Hollingsworth, Kieren G.; Taylor, Roy

2015-01-01

Objective Although impairment in pancreatic insulin secretion is known to precede the clinical diagnosis of type 2 diabetes by up to a decade, fasting blood glucose concentration only rises abnormally once the impairment reaches a critical threshold. Despite its centrality to the pathogenesis of type 2 diabetes, the pancreas is the least studied organ due to its inaccessible anatomical position. Previous ultrasound and CT studies have suggested a possible decrease in pancreatic volume in type 2 diabetes. However, ultrasound techniques are relatively insensitive while CT uses ionizing radiation, making these modalities unsuitable for precise, longitudinal studies designed to explore the underlying mechanisms of type 2 diabetes. Hence there is a need to develop a non-invasive, safe and precise method to quantitate pancreas volume. Methods We developed and applied magnetic resonance imaging at 3.0T to obtain balanced turbo field echo (BTFE) structural images of the pancreas, together with 3-point Dixon images to quantify pancreatic triglyceride content. Pancreas volume, morphology and triglyceride content was quantified in a group of 41 subjects with well-controlled type 2 diabetes (HbA1c ≤ 7.6%) taking only metformin (duration of T2DM 5.7±0.7years), and a control group of 14 normal glucose tolerance subjects matched for age, weight and sex. Results The mean pancreatic volume was found to be 33% less in type 2 diabetes than in normal glucose tolerant subjects (55.5±2.8 vs. 82.6±4.8cm3; pPancreas volume was positively correlated with HOMA-β in the type 2 diabetes subjects (r = 0.31; p = 0.03) and controls (r = 0.46; p = 0.05) considered separately; and in the whole population studied (r = 0.37; p = 0.003). In type 2 diabetes, the pancreas was typically involuted with a serrated border. Pancreatic triglyceride content was 23% greater (5.4±0.3 vs. 4.4±0.4%; p = 0.02) in the type 2 diabetes group. Conclusion This study describes for the first time gross

Pediatric pancreas transplantation, including total pancreatectomy with islet autotransplantation.

Science.gov (United States)

Bondoc, Alexander J; Abu-El-Haija, Maisam; Nathan, Jaimie D

2017-08-01

Unlike other solid-organ transplants, whole pancreas transplantation in children is relatively rare, and it occurs more frequently in the context of multivisceral or composite organ transplantation. Because children only infrequently suffer severe sequelae of type 1 diabetes mellitus, pancreas transplantation is rarely indicated in the pediatric population. More commonly, pediatric pancreas transplant occurs in the setting of incapacitating acute recurrent or chronic pancreatitis, specifically islet autotransplantation after total pancreatectomy. In this clinical scenario, total pancreatectomy removes the nidus of chronic pain and debilitation, while autologous islet transplantation aims to preserve endocrine function. The published experiences with pediatric total pancreatectomy with islet autotransplantation (TPIAT) in children has demonstrated excellent outcomes including liberation from chronic opioid use, as well as improved mental and physical quality of life with good glycemic control. Given the complexity of the operation, risk of postoperative complication, and long-term physiologic changes, appropriate patient selection and comprehensive multidisciplinary care teams are critical to ensuring optimal outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Renal cell carcinoma metastases to the pancreas - Value of arterial phase imaging at MDCT

International Nuclear Information System (INIS)

Corwin, Michael T.; Lamba, Ramit; McGahan, John P.; Wilson, Machelle

2013-01-01

Background: The pancreas is an increasingly recognized site of renal cell carcinoma metastases. It is important to determine the optimal MDCT protocol to best detect RCC metastases to the pancreas. Purpose: To compare the rate of detection of renal cell carcinoma metastases to the pancreas between arterial and portal venous phase MDCT. Material and Methods: A retrospective review of CTs of the abdomen yielded six patients with metastatic RCC to the pancreas. Five of six patients had pathologically proven clear cell RCC. Two blinded reviewers independently reported the number of pancreatic lesions seen in arterial and venous phases. Each lesion was graded as definite or possible. The number of lesions was determined by consensus review of both phases. Attenuation values were obtained for metastatic lesions and adjacent normal pancreas in both phases. Results: There were a total of 24 metastatic lesions to the pancreas. Reviewer 1 identified 20/24 (83.3%) lesions on the arterial phase images and 13/24 (54.2%) lesions on the venous phase. Seventeen of 20 (85.0%) arterial lesions were deemed definite and 9/13 (69.2%) venous lesions were definite. Reviewer 2 identified 19/24 (79.2%) lesions on the arterial phase and 14/24 (58.3%) on the venous phase. Seventeen of 19 (89.5%) arterial lesions were definite and 7/14 (50%) venous lesions were definite. Mean attenuation differential between lesion and pancreas was 114 HU and 39 HU for arterial and venous phases, respectively (P<0.0001). Conclusion: Detection of RCC metastases to the pancreas at MDCT is improved using arterial phase imaging compared to portal venous phase imaging

Simultaneous serous cystadenoma of the pancreas and mucinous cystadenoma of the appendix.

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Alrefaie, Waddah; Katz, Matthew H; Easter, David W; Yi, Eunhee S; Weidner, Noel; Savides, Thomas J; Moossa, Abdool R; Bouvet, Michael

2004-03-01

Serous cystadenoma of the pancreas and mucinous tumors of the vermiform appendix are rare. To our knowledge, the simultaneous occurrence of these two tumors has not been reported. Here, we report an adult female who presented with signs and symptoms of appendicitis. A preoperative CT scan confirmed the findings of appendicitis and also showed an incidental large mass in the head of the pancreas. The patient underwent uneventful appendectomy. Her pathology revealed an acutely inflamed appendix with a benign mucinous cystadenoma at the tip. Several months after her recovery, a Whipple procedure was performed. Pathologic examination showed a 5x5 cm serous cystadenoma of the head of the pancreas without evidence of malignancy. Two years later, the patient is alive and well without evidence of tumor recurrence. Cystadenomas of the pancreas and appendix are unusual and their simultaneous occurrence is a rare event.

An artificial pancreas for automated blood glucose control in patients with Type 1 diabetes

DEFF Research Database (Denmark)

Schmidt, Signe; Boiroux, Dimitri; Ranjan, Ajenthen

2015-01-01

Automated glucose control in patients with Type 1 diabetes is much-coveted by patients, relatives and healthcare professionals. It is the expectation that a system for automated control, also know as an artificial pancreas, will improve glucose control, reduce the risk of diabetes complications...... and markedly improve patient quality of life. An artificial pancreas consists of portable devices for glucose sensing and insulin delivery which are controlled by an algorithm residing on a computer. The technology is still under development and currently no artificial pancreas is commercially available....... This review gives an introduction to recent progress, challenges and future prospects within the field of artificial pancreas research....

Thoracic fistulas of the pancreas and their complications in childhood

Energy Technology Data Exchange (ETDEWEB)

Fritsch, R; Schirg, E; Buerger, D

1981-08-01

The article reports on two thoracic fistulas of the pancreas in infants. Anamnesis revealed that recurring abdominal pain had occured in those children for years; at the time of their admission to hospital there was considerable dyspnoea with thoracic pain depending on the respiration. Fistulas of the pancreas with thoracic connection were identified as the cause. The article goes into the details of genesis, differential diagnosis and course of the disease.

An unusual mixed tumor of the pancreas: sonographic and MDCT features.

Science.gov (United States)

Mortelé, Koenraad J; Peters, Hope E; Odze, Robert D; Glickman, Jonathan N; Jajoo, Kunal; Banks, Peter A

2009-03-09

Mixed tumors of the pancreas are exceedingly rare. We herein report on a 54-year-old female who presented with an enlarging cystic lesion in the head of the pancreas. Right upper quadrant ultrasound and multidetector-row CT scan showed a well-defined unilocular cystic tumor located in the head of the pancreas and surrounded, in part, by a hypervascular solid mass. Although mixed exocrine/endocrine pancreatic tumors have been described previously, to the best of our knowledge, this is the first case of a pancreatic mixed intraductal papillary mucinous neoplasm/endocrine tumor with illustration of its ultrasound and CT features. Moreover, the importance of preoperative analysis of imaging features in the assessment of pancreatic neoplasms is discussed.

Serous Cystadenoma of the Pancreas Presenting as a Third Primary Neoplasm

Directory of Open Access Journals (Sweden)

Aydın Şeref Köksal

2003-01-01

Full Text Available Serous cystadenomas are the most common cystic neoplasms of the pancreas. They may occur solely or coexist with other neoplasms. A 10 cm mass involving the body of the pancreas was observed in the computed tomography of a 61-year-old man with a previous history of bladder and prostate carcinoma. Ultrasonography and computed tomography of the mass demonstrated multiple small cysts associated with a central calcified scar. A distal pancreatectomy was performed. Pathological examination confirmed the diagnosis of serous microcystic adenoma. This is the first report of a serous cystadenoma of the pancreas with two metachronous neoplasms. This feature should be kept in mind during the diagnosis and evaluation of patients with serous cystadenoma.

Pre-surgical radiologic diagnostics of pancreas diseases

International Nuclear Information System (INIS)

Seifried, C.

1979-01-01

At the example of a comparative study with 112 patients it should be demonstrated that the different radiologic techniques are complementary in pancreas diagnostics with respect to their indication and proposition. The study yields the following procedure for the pancreas diagnostics: cysts and pancreatites are diagnosed by means of sonography and computed tomography. Stomach-colon-barium passage and intravenous cholangio cholecystography can be applied for clarification of functional reactions on the stomach-colon regions, respectively the biliary region. Only in a complicated process, e.g. in a sustaining tumor suspicion or before surgery should angiography be used. In pancreatitis also the endoscopic retrograde cholangio-pancreatiography is used. Tumors are generally submitted to angiography for clarification of diagnosis, resiscivity, and vessel conditions. (orig./MG) [de

Cancer of the Pancreas: Molecular Pathways and Current Advancement in Treatment.

Science.gov (United States)

Polireddy, Kishore; Chen, Qi

2016-01-01

Pancreatic cancer is one of the most lethal cancers among all malignances, with a median overall survival of cancers harbor a variety of genetic alternations that render it difficult to treat even with targeted therapy. Recent studies revealed that pancreatic cancers are highly enriched with a cancer stem cell (CSC) population, which is resistant to chemotherapeutic drugs, and therefore escapes chemotherapy and promotes tumor recurrence. Cancer cell epithelial to mesenchymal transition (EMT) is highly associated with metastasis, generation of CSCs, and treatment resistance in pancreatic cancer. Reviewed here are the molecular biology of pancreatic cancer, the major signaling pathways regulating pancreatic cancer EMT and CSCs, and the advancement in current clinical and experimental treatments for pancreatic cancer.

Periduodenal Tuberculosis masquerading as Annular Pancreas ...

African Journals Online (AJOL)

We report a patient who succumbed to an isolated mid duodenal tuberculosis, diagnosed at laparatomy, whose clinical presentation, endoscopy and computerised tomography scans resembled annular pancreas. The limitations of clinical evaluation, endoscopy and radiology are highlighted as the importance of diagnostic ...

Positron Scanning of Liver and Pancreas; Exploration de Foie et du Pancreas par les Positrons; Pozitronoskopiya pecheni i podzheludochnoj zhelezy; Exploracion del higado y del pancreas mediante positrones

Energy Technology Data Exchange (ETDEWEB)

Aronow, S; Thors, R; Brownell, G L [Physics Research Laboratory and Department of Surgery, Massachusetts General Hospital, Boston, MA (United States)

1959-07-01

The success of the positron scanning technique in the localization of brain tumors has suggested its application to other organs. Zinc-62 is used in an attempt to delineate the pancreas and copper-64 in various forms is used to delineate the liver. The problem of visualizing the pancreas is particularly difficult because of its small size and the presence of large organs in the vicinity which concentrate zinc. Several approaches to this problem are discussed. Copper-64 in simple ionic form and in the form of copper versenate concentrate to a marked degree in the liver. Positron scans of the liver would seem to offer considerable promise for successful 'diagnosis of various liver disorders. Data is presented on the distribution of several isotopes and compounds in animals. (author) [French] Devant le succes avec lequel la technique de detection par les positrons a ete utilisee pour la localisation des tumeurs du cerveau, on a ete amene a l'appliquer a d'autres organes. On s'est servi de zinc-62 pour tenter de determiner le contour du pancreas, et de cuivre-64, sous diverses formes, pour le contour du foie. Il est particulieremen t difficile de rendre visible le pancreas en raison de sa petite taille et de la presence d'organes voisins de grandes dimensions, qui concentrent le zinc. Les auteurs etudient plusieurs procedes par lesquels on s'est efforce de resoudre ce probleme. Le cuivre-64 sous forme ionique simple et sous forme de sel de l'acide ethylene-diamino-tetra-acetique se ooncentre fortement dans le foie. L'exploration du foie a l'aide des positrons parait devoir faciliter considerablemen t le diagnostic de differents troubles hepatiques. Les auteurs donnent des indications sur la repartition de plusieurs isotopes et composes chez des animaux. (author) [Spanish] El exito de la tecnica de exploracion mediante positrones en la localization de tumores cerebrales aconseja su aplicacion a otros organos. El zinc-62 y el cobre-64 en diferentes formas se utilizan

Triphasic contrast enhanced CT simulation with bolus tracking for pancreas SBRT target delineation.

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Godfrey, Devon J; Patel, Bhavik N; Adamson, Justus D; Subashi, Ergys; Salama, Joseph K; Palta, Manisha

Bolus-tracked multiphasic contrast computed tomography (CT) is often used in diagnostic radiology to enhance the visibility of pancreas tumors, but is uncommon in radiation therapy pancreas CT simulation, and its impact on gross tumor volume (GTV) delineation is unknown. This study evaluates the lesion conspicuity and consistency of pancreas stereotactic body radiation therapy (SBRT) GTVs contoured in the different contrast phases of triphasic CT simulation scans. Triphasic, bolus-tracked planning CT simulation scans of 10 consecutive pancreas SBRT patients were acquired, yielding images of the pancreas during the late arterial (LA), portal venous (PV), and either the early arterial or delayed phase. GTVs were contoured on each phase by a gastrointestinal-specialized radiation oncologist and reviewed by a fellowship-trained abdominal radiologist who specializes in pancreatic imaging. The volumes of the registered GTVs, their overlap ratio, and the 3-dimensional margin expansions necessary for each GTV to fully encompass GTVs from the other phases were calculated. The contrast difference between tumor and normal pancreas was measured, and 2 radiation oncologists rank-ordered the phases according to their value for the lesion-contouring task. Tumor-to-pancreas enhancement was on average much larger for the LA and PV than the delayed phase or early arterial phases; the LA and PV phases were also consistently preferred by the radiation oncologists. Enhancement differences among the phases resulted in highly variable GTV volumes with no observed trends. Overlap ratios ranged from 18% to 75% across all 3 phases, improving to 43% to 91% when considering only the preferred LA and PV phases. GTV expansions necessary to encompass all GTVs ranged from 0.3 to 1.8 cm for all 3 phases, improving slightly to 0.1 to 1.4 cm when considering just the LA and PV phases. For pancreas SBRT, we recommend combining the GTVs from a multiphasic CT simulation with bolus-tracking, including

A pancreas imaging agent-131I-HIPDM: the animal experiment and preliminary clinical application