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Southern African Journal of Anaesthesia and Analgesia. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 1 (2003) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Preoperative diagnosis of malignant ...

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

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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

[Usefullness of scintigraphy with somatostatin analogues in the imaging of insulinoma of the pancreas].

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Owecki, Maciej; Czepczyriński, Rafał; Biczysko, Maciej; Stawny, Bolesław; Drews, Michał; Sowiński, Jerzy

2006-01-01

We present a case of a 74-years-old female with insulinoma of the pancreas. Neuroglycopenic symptoms (Whipple's triad) and a positive fast test established the diagnosis. The fast was terminated after 5 hours and 40 minutes because of neuroglycopenic symptoms with the serum glucose and insulin levels of 40 mg/dl and 34,01 microU/ml respectively. The tumor was invisible in ultrasound, abdominal CT scan and MRL The only means that enabled preoperative visualization was 111-Indium labeled octreotide scintigraphy (OctreoScan). Laparotomy was performed, and a tumor was disclosed in intraoperative ultrasonography within the head of the pancreas. The tumor of 37 mm diameter was excised. Histopatological examination revealed benign insulinoma. After surgery the symptoms alleviated completely. The patient with proper glucose levels and insulin concentration of 3,04 microU/ml was discharged in good health. This case confirms high usefulness of preoperative OctreoScan and intraoperative ultrasonography in the approach to a patient with insulinoma.

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.

Differential Diagnosis of Cystic Lymphangioma of the Pancreas Based on Imaging Features

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Ting-Kai Leung

2006-01-01

Full Text Available Lymphangioma is a benign tumor, which is a consequence of lymphatic malformation with blockage of lymphatic flow. Most lymphangiomas occur in the neck and axillary region, and < 1% occur in the mesentery or retroperitoneum. Lymphangiomas arising from the pancreas are extremely rare. We report the case of a 34-year-old woman with cystic lymphangioma of the pancreas without major symptoms or signs. A 6 × 6 cm intra-abdominal cystic mass was incidentally revealed by sonography during a health examination. It is always a challenge to differentiate the lesion from other possible cystic-like pancreatic neoplasms. Differential diagnosis of cystic lymphangioma from other cystic-like tumors of the pancreas can be performed based on their imaging characteristics, including presence of septa, cystic or wall calcification, soft tissue, wall thickness, single or multiple loculation, and dilatation of the pancreatic duct. Post-gadolinium magnetic resonance imaging is excellent in defining the origin of intra-abdominal cystic mass and intracystic septa.

Preoperative diagnosis of carcinoma within fibroadenoma on screening mammograms

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Borecky, N.; Rickard, M.

2008-01-01

Three cases of fibroadenoma associated with carcinoma are reported. These cases were diagnosed within a screening programme as a result of suspicious mammographic findings, and the diagnosis of malignancy was confirmed preoperatively by core biopsy in all cases. The mammographic findings suggestive of carcinoma within fibroadenoma were irregularity of margins in one case and associated new suspicious pleomorphic and linear calcifications in the two other cases. The preoperative diagnosis of carcinoma within fibroadenoma was provided by ultrasound-guided core biopsy in two cases and core biopsy under stereotactic guidance in one case. Whereas asymptomatic fibroadenoma with benign imaging appearances usually does not require further investigation, fibroadenoma with atypical imaging features requires a triple test investigation.

Usefulness of intraoperative echography for resection of a insulinoma located in the head of pancreas

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Cepero Valdes, Manuel; Hernandez Rivero, Hanoi; Ugarte Moreno, Dayana; Chao Gonzalez, Lissette

2011-01-01

The insulinoma is the more frequent neoplasms among the neuroendocrine tumors of pancreas. The aim of present paper is to describe the clinical picture, laboratory and imaging examinations and the surgical features as well as the complications in a patient diagnosed with insulinoma without evidences by preoperative images. Surgery was prescribed on the base of clinical and analytic evidences of hypoglycemia and hyperinsulinism and the carrying out of an exploratory laparatomy without any lesion with direct palpation of pancreas. Intraoperative echography was used to locate a 0,8 cm nodule in the head of pancreas. After enucleation the only postoperative complication was a low-flow pancreatic fistula with a spontaneous remission. The histological diagnosis was a benign insulinoma. Patient had a clinical reversion of symptoms in addition to normalization of glycemia values, compared to those intraoperative. (author)

Portal Annular Pancreas

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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

Torsion of the greater omentum: A rare preoperative diagnosis

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Tandon, Ankit Anil; Lim, Kian Soon

2010-01-01

Torsion of the greater omentum is a rare acute abdominal condition that is seldom diagnosed preoperatively. We report the characteristic computed tomography (CT) scan findings and the clinical implications of this unusual diagnosis in a 41-year-old man, who also had longstanding right inguinal hernia. Awareness of omental torsion as a differential diagnosis in the acute abdomen setting is necessary for correct patient management

Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI

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Wang, Zhen J.; Daldrup-Link, Heike; Coakley, Fergus V.; Yeh, Benjamin M. [University of California, San Francisco (United States). Department of Radiology

2010-03-15

Uterine didelphys with obstructed hemivagina and ipsilateral renal anomalies is a rare congenital malformation of the female urogenital tract. While the urinary anomalies almost always involve renal agenesis, we report a rare case of a 17-year-old girl with the malformation associated with ectopic ureteral insertion into the obstructed hemivagina, which was diagnosed preoperatively by MR imaging. To the best of our knowledge, preoperative MR imaging diagnosis of the ectopic ureter associated with this syndrome has not been previously reported. Accurate preoperative diagnosis of ectopic ureteral insertion associated with this syndrome is important for surgical planning. (orig.)

Ectopic ureter associated with uterine didelphys and obstructed hemivagina: preoperative diagnosis by MRI

International Nuclear Information System (INIS)

Wang, Zhen J.; Daldrup-Link, Heike; Coakley, Fergus V.; Yeh, Benjamin M.

2010-01-01

Uterine didelphys with obstructed hemivagina and ipsilateral renal anomalies is a rare congenital malformation of the female urogenital tract. While the urinary anomalies almost always involve renal agenesis, we report a rare case of a 17-year-old girl with the malformation associated with ectopic ureteral insertion into the obstructed hemivagina, which was diagnosed preoperatively by MR imaging. To the best of our knowledge, preoperative MR imaging diagnosis of the ectopic ureter associated with this syndrome has not been previously reported. Accurate preoperative diagnosis of ectopic ureteral insertion associated with this syndrome is important for surgical planning. (orig.)

Preoperative CEA and CA 19-9 are prognostic markers for survival after curative resection for ductal adenocarcinoma of the pancreas - a retrospective tumor marker prognostic study.

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Distler, Marius; Pilarsky, Eva; Kersting, Stephan; Grützmann, Robert

2013-01-01

The prognosis for patients with ductal adenocarcinoma of the pancreas (PDAC) remains poor even after curative resection. Carbohydrate antigen 19-9 (CA 19-9) and the carcinoembryonic antigen (CEA) are the most widely used serum-based tumor markers for the diagnosis and follow up of pancreatic cancer. In our analysis we aim to assess the prognostic value of a combination of both tumor markers in patients with pancreatic ductal adenocarcinoma (PDAC). Between 01/1995 and 08/2012 we performed a total of 264 pancreatic resections due to PDAC. Patients were stratified into 3 groups in regard to their preoperative tumor marker levels. Survival was compared between the groups using Kaplan Meier analysis and log rank test. Univariate subgroup analysis and multivariate analysis were performed. For 259 cases complete follow up could be obtained. In patients with low preoperative CEA and CA 19-9 levels (group 1 n = 91) the mean survival was 33.3 month (CI 95% 25.1-41.5). If one of the analyzed tumor markers (CEA/CA19-9) was preoperatively elevated above the cut-off level (group 2 n = 106) mean survival was 28.5 month (CI 95% 22.1-35.1). 62 patients showed preoperative elevation of both, CEA and CA 19-9 (group 3); mean survival in this group was 23.9 month (CI 95% 13.9-33.9), p > 0.01. Multivariate analysis confirmed preoperative CEA/CA 19-9 level as independent prognostic factor (HR 1.299). Preoperative CEA and CA 19-9 levels correlate with patient prognosis after curative pancreatic resection due to PDAC. This is especially true for the most frequently pT 3/4 stages of PDAC. Even if CEA and CA 19-9 might not be appropriate for screening, its serum levels should therefore be determined prior to operation and taken into account when resectability or operability is doubtful. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Preoperative diagnosis of lymph node metastasis in thoracic esophageal cancer

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Eguchi, Reiki; Yamada, Akiyoshi; Ueno, Keiko; Murata, Yoko [Tokyo Women`s Medical Coll. (Japan)

1996-10-01

From 1994 to 1995, to evaluate the utility of preoperative CT, EUS (endoscopic ultrasonography) and US in the diagnosis of lymph node metastasis in thoracic esophageal cancer, 94 patients with thoracic esophageal cancer who underwent esophagectomy were studied clinicopathologically. The sensitivity of EUS diagnosis of upper mediastinal lymph node metastasis (85%), left-sided paragastrin lymph node metastasis (73-77%), and especially lower paraesophageal lymph node metastasis (100%) were good. But due to their low-grade specificity in EUS diagnosis, their overall accuracy was not very good. On the other hand, the overall accuracy of the CT diagnosis of lymph node metastasis was fine. However, sensitivity, the most important clinical factor in the CT diagnosis of lymph node metastasis was considerably inferior to EUS. The assessment of the diagnosis of lymph node metastasis around the tracheal bifurcation and the pulmonary hilum and the left para-cardial lesion by CT or EUS was poor. It was concluded that lymph node metastasis of these area must be the pitfall in preoperative diagnosis. The average diameter of the lymph nodes and the proportion of cancerous tissue in the lymph nodes diagnosed as metastatic lymph nodes by CT was larger than that of the false negative lymph nodes. However, the lymph nodes diagnosed as true positives by EUS showed no such tendency. This must be the reason the sensitivity of the EUS diagnosis and specificity of the CT diagnosis were favorable, but the specificity of the EUS diagnosis and especially the sensitivity of the CT diagnosis were not as good. (author)

Preoperative diagnosis of lymph node metastasis in thoracic esophageal cancer

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Eguchi, Reiki; Yamada, Akiyoshi; Ueno, Keiko; Murata, Yoko

1996-01-01

From 1994 to 1995, to evaluate the utility of preoperative CT, EUS (endoscopic ultrasonography) and US in the diagnosis of lymph node metastasis in thoracic esophageal cancer, 94 patients with thoracic esophageal cancer who underwent esophagectomy were studied clinicopathologically. The sensitivity of EUS diagnosis of upper mediastinal lymph node metastasis (85%), left-sided paragastrin lymph node metastasis (73-77%), and especially lower paraesophageal lymph node metastasis (100%) were good. But due to their low-grade specificity in EUS diagnosis, their overall accuracy was not very good. On the other hand, the overall accuracy of the CT diagnosis of lymph node metastasis was fine. However, sensitivity, the most important clinical factor in the CT diagnosis of lymph node metastasis was considerably inferior to EUS. The assessment of the diagnosis of lymph node metastasis around the tracheal bifurcation and the pulmonary hilum and the left para-cardial lesion by CT or EUS was poor. It was concluded that lymph node metastasis of these area must be the pitfall in preoperative diagnosis. The average diameter of the lymph nodes and the proportion of cancerous tissue in the lymph nodes diagnosed as metastatic lymph nodes by CT was larger than that of the false negative lymph nodes. However, the lymph nodes diagnosed as true positives by EUS showed no such tendency. This must be the reason the sensitivity of the EUS diagnosis and specificity of the CT diagnosis were favorable, but the specificity of the EUS diagnosis and especially the sensitivity of the CT diagnosis were not as good. (author)

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

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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

Sensitivity of endoscopic ultrasound, multidetector computed tomography, and magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum: a tertiary center experience.

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Kushnir, Vladimir M; Wani, Sachin B; Fowler, Kathryn; Menias, Christine; Varma, Rakesh; Narra, Vamsi; Hovis, Christine; Murad, Faris M; Mullady, Daniel K; Jonnalagadda, Sreenivasa S; Early, Dayna S; Edmundowicz, Steven A; Azar, Riad R

2013-04-01

There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: (1) evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP), and multidetector computed tomography (MDCT) for pancreas divisum; and (2) assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP. For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent endoscopic retrograde pancreatography and cross-sectional imaging. The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than the sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) (P pancreas divisum; IOA was moderate (κ = 0.43). Endoscopic ultrasound is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum.

Preoperative Diagnosis of Adult Intussusception Caused by Small Bowel Lipoma

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Hiroaki Shiba

2009-11-01

Full Text Available Adult intussusception is rare, accounting for only 5% of all intussusceptions, for which preoperative diagnosis is difficult. We herein report a preoperatively diagnosed case of adult intussusception caused by a small bowel lipoma. A 33-year-old man was admitted to our hospital with three weeks history of colicky epigastric pain. Computed tomography revealed thickening of the ileal wall suggestive of intussusception. Colonoscopy revealed an ileocolic intussusception. Barium enema for reduction of ileocolic intussusception demonstrated a small bowel tumor in the ileum 15 cm proximal to the ileocecal valve. The intussusception was reduced, and the patient underwent partial resection of the ileum encompassing the small bowel tumor. Histological findings confirmed the diagnosis of lipoma of the small bowel. The patient made a satisfactory recovery and remains well.

Branchial cleft anomalies: accuracy of pre-operative diagnosis, clinical presentation and management.

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Guldfred, L-A; Philipsen, B B; Siim, C

2012-06-01

To examine the accuracy of the pre-operative diagnosis of branchial cleft anomalies, and also to describe their occurrence, clinical presentation and management. Retrospective review of the records of patients diagnosed with a branchial cleft anomaly between 1997 and 2006. One hundred and twenty-six patients were included. Pre-operative diagnosis had a positive predictive value of 0.856 (95 per cent confidence interval, 0.771-0.918) and a sensitivity of 0.944 (95 per cent confidence interval, 0.869-0.979). These patients' demographic data, investigations, findings and management are presented, along with a possible strategy for dealing with solitary cystic masses in the neck. As pre-operative diagnosis has a positive predictive value of 86 per cent, cystic lesions in the neck should be presumed to be carcinomatous until proven otherwise. Branchial fistulae and sinuses seem to be a disease of childhood, while branchial cysts occur mainly in adults. Branchial cleft anomalies are equally frequent in men and women, and equally distributed on the left and right side of the neck.

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

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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.

Prognostic factors and diagnosis of extent of the bile duct cancer

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Kai, Masahiro; Chijiiwa, Kazuo; Otani, Kazuhiro; Ouchida, Jiro; Kondo, Kazuhiro; Nagano, Motoaki; Hiyoshi, Masahide; Imamura, Naoya

2009-01-01

To improve the survival of the patients with extrahepatic bile duct cancer, the factors influencing survival and the accuracy of preoperative diagnosis were examined. The factors influencing survival were retrospectively analyzed in 115 patients (mid and lower; n=61, hilar and superior; n=44, diffusely spread; n=10) with extrahepatic bile duct cancer who underwent surgical resection from 1990 to 2008. The preoperative diagnosis of the tumor extension using multi detector row CT (MDCT), endoscopic retrograde cholangiopancreatography (ERCP), intraductal ultrasonography (IDUS) and endoscopic ultrasonography (EUS) was compared with the final pathological diagnosis in patients underwent surgical resection (mid and lower; n=32, hilar and superior; n=11, diffusely spread; n=8) from 2003 to 2008. In patients with mid and lower bile duct cancer (n=61), lymph node metastasis and surgical margin were the independent prognostic factors in the multivariate analysis. Whereas none was found in hilar and superior bile duct cancer (n=44). The sensitivity, specificity and accuracy of the preoperative diagnosis for the depth of tumor invasion (serosal and/or pancreas invasion) was 66.7%, 69.4% and 68.6%, and for the liver invasion was 100%, 88.0%, 88.2%, and for the lymph node metastasis was 76.9%, 71.0%, 72.5%, respectively. More than a few cases were under diagnosed the tumor extension. In patients with mid and lower bile duct cancer, the accuracy of preoperative diagnosis for the depth of tumor invasion (serosal and/or pancreas) was 59.4%. In patients with hilar and superior bile duct cancer, the accuracy of preoperative diagnosis for the serosal and hepatic invasion is 81.8% and 54.5%. Positive surgical margin was 9.1% for hilar and superior, 9.4% for mid and lower and 50.0% for diffusely spread bile duct cancer. Especially, The horizontal spread was difficult to evaluate in patients with diffusely spread bile duct cancer. From 2003 to 2008, the rate of positive surgical margin

Radiology of the pancreas

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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.)

Consistency of the preoperative and intraoperative diagnosis of benign vocal fold lesions

NARCIS (Netherlands)

Poels, PJP; de Jong, FICRS; Schutte, HK

The purpose of this retrospective study was to compare the preoperative and intraoperative diagnosis of benign vocal fold lesions for consistency. The diagnosis was made in 221 consecutive patients with benign vocal fold lesions for which a microlaryngoscopy was carried out in a general ENT-clinic.

Mixed acinar-endocrine carcinoma of the pancreas: new clinical and pathological features in a contemporary series.

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Yu, Run; Jih, Lily; Zhai, Jing; Nissen, Nicholas N; Colquhoun, Steven; Wolin, Edward; Dhall, Deepti

2013-04-01

The objective of this study was to characterize the novel clinical and pathological features of mixed acinar-endocrine carcinoma of the pancreas. This was a retrospective review of medical records and surgical pathology specimens of patients with a diagnosis of mixed acinar-endocrine carcinoma of the pancreas at Cedars-Sinai Medical Center between 2005 and 2011. Additional immunohistochemistry was performed on the specimens of some patients. Five patients were identified. The median age at presentation was 74 years (range, 59-89 years), and all patients were male. The presenting symptoms were all related to tumor mass effects. The median size of the tumor was 10 cm (range, 3.9-16 cm). Preoperative clinical diagnosis aided by fine-needle aspiration biopsy was incorrect in all 5 cases. Most tumors (3/5) exhibited predominantly endocrine differentiation without hormonal production. Only 10% to 30% of cells were truly amphicrine, whereas most were differentiated into either endocrine or acinar phenotype. The clinical behavior ranged from moderate to aggressive with postoperative survival from 2.5 months to more than 3 years. Four patients received neoadjuvant or adjuvant chemotherapy with variable responses. Mixed acinar-endocrine carcinoma of the pancreas appears to be not uncommon in men, may harbor predominantly endocrine component, is often misdiagnosed by cytology, and exhibits variable clinical behavior. Mixed acinar-endocrine carcinoma of the pancreas should be considered in older patients with sizable pancreatic mass and may warrant aggressive surgical resection and chemotherapy.

SENSITIVITY OF ENDOSCOPIC ULTRASOUND, MULTIDETECTOR COMPUTER TOMOGRAPHY AND MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY IN THE DIAGNOSIS OF PANCREAS DIVISUM: A TERTIARY CENTER EXPERIENCE

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Kushnir, Vladimir M.; Wani, Sachin B.; Fowler, Kathryn; Menias, Christine; Varma, Rakesh; Narra, Vamsi; Hovis, Christine; Murad, Faris; Mullady, Daniel; Jonnalagadda, Sreenivasa S.; Early, Dayna S.; Edmundowicz, Steven A.; Azar, Riad R.

2014-01-01

OBJECTIVES There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: 1. Evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP) and multi-detector computed tomography (MDCT) for pancreas divisum. 2. Assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP. METHODS For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography (ERP) who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent ERP and cross-sectional imaging. RESULTS The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) [ppancreas divisum; IOA was moderate (қ=0.43). CONCLUSIONS EUS is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum. PMID:23211370

Impact of preoperative diagnosis on patient satisfaction following lumbar spine surgery.

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Crawford, Charles H; Carreon, Leah Y; Bydon, Mohamad; Asher, Anthony L; Glassman, Steven D

2017-06-01

OBJECTIVE Patient satisfaction is a commonly used metric in the current health care environment. While factors that affect patient satisfaction following spine surgery are complex, the authors of this study hypothesized that specific diagnostic groups of patients are more likely to be satisfied after spine surgery and that this is reflected in patient-reported outcome measures. The purpose of this study was to determine if the preoperative diagnosis-disc herniation, stenosis, spondylolisthesis, adjacent segment degeneration, or mechanical disc collapse-would impact patient satisfaction following surgery. METHODS Patients enrolled in the Quality Outcomes Database, formerly known as the National Neurosurgery Quality and Outcomes Database (N 2 QOD), completed patient-reported outcome measures, including the Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) for back pain (NRS-BP) and leg pain (NRS-LP) preoperatively and 1-year postoperatively. Patients were stratified by diagnosis and by their response to the satisfaction question: 1) surgery met my expectations; 2) I did not improve as much as I hoped, but I would undergo the same operation for the same results; 3) surgery helped, but I would not undergo the same operation for the same results; or 4) I am the same or worse as compared with before surgery. RESULTS A greater proportion of patients with primary disc herniation or spondylolisthesis reported that surgery met expectations (66% and 67%, respectively), followed by recurrent disc herniation and stenosis (59% and 60%, respectively). A smaller proportion of patients who underwent surgery for adjacent segment degeneration or mechanical disc collapse had their expectations met (48% and 41%, respectively). The percentage of patients that would undergo the same surgery again, by diagnostic group, was as follows: disc herniation 88%, recurrent disc herniation 79%, spondylolisthesis 86%, stenosis 82%, adjacent segment disease 75%, and mechanical collapse

Preoperative diagnosis of pelvic actinomycosis by clinical cytology

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Matsuda K

2012-09-01

Full Text Available Katsuya Matsuda,1 Hisayoshi Nakajima,2 Khaleque N Khan,1 Terumi Tanigawa,1 Daisuke Hamaguchi,1 Michio Kitajima,1 Koichi Hiraki,1 Shingo Moriyama,3 Hideaki Masuzaki11Department of Obstetrics and Gynecology, Nagasaki University Graduate School of Biomedical Sciences, 2Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, 3Shimabara Maternity Clinic, Nagasaki, JapanBackground: The purpose of this work was to investigate whether clinical cytology could be useful in the preoperative diagnosis of pelvic actinomycosis.Methods: This study involved the prospective collection of samples derived from the endometrium and the uterine cervix, and retrospective data analysis. Nine patients with clinically diagnosed pelvic actinomycosis were enrolled. The clinical and hematological characteristics of patients were recorded, and detection of actinomyces was performed by cytology, pathology, and bacteriological culture of samples and by imprint intrauterine contraceptive device (IUD cytology.Results: The detection rate of actinomyces was 77.7% by combined cervical and endometrial cytology, 50.0% by pathology, and 11.1% by bacterial culture.Conclusion: The higher detection rate of actinomyces by cytology than by pathology or bacteriology suggests that careful cytological examination may be clinically useful in the preoperative diagnosis of pelvic actinomycosis.Keywords: actinomycosis, cytology, pathology, intrauterine contraceptive device, pelvic inflammatory disease

Torsion of wandering spleen and distal pancreas

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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

Primary hyperparathyroidism, adrenal tumors and neuroendocrine tumors of the pancreas - clinical diagnosis and imaging requirements

International Nuclear Information System (INIS)

Auernhammer, C.J.; Engelhardt, D.; Goeke, B.

2003-01-01

Diseases of the parathyroids, the adrenals and of neuroendocrine tumors of the pancreas are primarily diagnosed by clinical and endocrinological evaluation.The requirements concerning various imaging techniques and their relative importance in localization strategies of the different tumors are complex. Current literature search, using PubMed. Evaluation of primary hyperparathyroidism requires bone densitometry by DXA and search for nephrolithiasis by ultrasound or native CT examination.While ultrasound of the thyroid and parathyroids seems useful before any parathyroid surgery,more extensive preoperative localization strategies (sestamibi scintigraphy, MRI) should be restricted to minimal invasive parathyroid surgery or re-operations.For adrenal tumors CT and MRI are of similar diagnostic value. Imaging of pheochromocytomas should be completed by MIBG scintigraphy. Each adrenal incidentaloma requires an endocrinological work-up.A fine-needle aspiration or core needle biopsy of an adrenal tumor is rarely indicated.Before adrenal biopsy a pheochromocytoma has to be excluded.Successful localization strategies for neuroendocrine tumors of the pancreas include somatostatin receptor scintigraphy, endoscopic ultrasound and MRI.Discussion Specific localization strategies have been established for the aforementioned tumors.The continuous progress of different imaging techniques requires a regular reevaluation of these localization strategies. (orig.) [de

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.

Endoscopic findings following retroperitoneal pancreas transplantation.

Science.gov (United States)

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.

Computed tomographic criteria for differential diagnosis between exacerbation of focal chronic pancreatitis and carcinoma located in the head of the pancreas

International Nuclear Information System (INIS)

Ivanov, A.; Tonchev, Z.

1995-01-01

A group of 126 patients with CT-finding of tumor mass in the head of the pancreas is studied. Signs of acute exacerbation of focal chronic pancreatitis are found in 28 of them. Carcinoma of the head of pancreas is diagnosed in 98 patients. Surgical and histological verification is performed in 84 (86%) patients with carcinoma of the pancreas. In 77 (92%) cases the computed tomographic diagnosis coincides with the histological one, while in the remaining 7 (8%) it fails to coincide. The morphological and densitometric changes were analyzed with respect to their frequency. On account of the nonspecific character of the computed tomographic signs a symptom constellation is developed which facilitates the differential diagnosis of the acute exacerbation of focal pancreatitis and the carcinoma. The changes in density of lesions observed after application of contrast media were found to be of significant value. 16 refs., 6 figs. (author)

Primary muscular hydatid: preoperative diagnosis Throught computerized tomography and ultrasonography

International Nuclear Information System (INIS)

Macho Fernandez, J.M.; Marin Cardenas, M.A.; Mazas Artasona, L.; Lample Lacasa, C.; Otero Sierra, C.; Hernandez Navarrete, M.J.; Gomez-Pereda, R.

1995-01-01

Primary muscular hydatid disease, is extremely rare,- but not exceptional-, comparatively with other atypical localization. In this article the authors revised 474 patients with hydatid disease over a ten years period. Three cases of primary muscular localization were found. The ultrasonography and computed tomography facilitates the preoperative diagnosis. (Author) 40 refs

Preoperative diagnosis of Amyand's hernia by ultrasound and computed tomography

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Husam Vehbi

2016-06-01

Full Text Available Inguinal hernia is the most common seen groin hernias which mostly contain bowel. The incidence of vermiform appendix in an inguinal hernia is seen in 1% of all inguinal hernia. This is known as Amyand's hernia. Appendix within a hernia can be normal or complicated by appendicitis. Most of these cases are not diagnosed preoperatively and managed during surgery. Preoperative diagnosis of these cases is so rare. Very few cases have been reported so far.In our case, we diagnosed an inflamed appendix in a 49 years old female within right inguinal hernia by using ultrasound and confirmed it by CT scan. Keywords: Amyand's hernia, Appendicitis

Pancreas and cyst segmentation

Science.gov (United States)

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.

Laboratory diagnosis of pancreatitis and cancer of the pancreas

International Nuclear Information System (INIS)

Degtyareva, I.I.; Gajsenko, A.V.; Putseva, N.M.

1989-01-01

The content of fibrin fibrinogen splitting products (FSP), radioimmune trypsine, C-peptide and carbohydrate antigen (CA) 19-9 in the blood of 82 patients with acute pancreatitis (edematous and hemorrhagic), and chronic recurrent pancreatitis at the stage of exacerbation, 42 patients with chronic pancreatitis, 34 patients with cancer of the pancreas (stages 3-4) and 22 healthy persons were studied. Results indicate a high diagnostic value of determination FSP, trypsin and C-peptide in patients with acute pancreatitis and chronic recurring pancreatitis at the stage of exacerbation, trypsin and C-peptide in patients with chronic pancreatitis associated with severe exocrinous insufficiency of the pancreas, KA 19-9 in patients with cancer of the pancreas

Preoperative Cytologic Diagnosis of Warthin-like Variant of Papillary Thyroid Carcinoma

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Jisup Kim

2018-03-01

Full Text Available Background Warthin-like variant of papillary thyroid carcinoma (WLV-PTC is a relatively rare variant of papillary thyroid carcinoma with favorable prognosis. However, preoperative diagnosis using fine-needle aspiration (FNA specimens is challenging especially with lymphocytic thyroiditis characterized by Hürthle cells and lymphocytic background. To determine a helpful cytological differential point, we compared WLV-PTC FNA findings with conventional papillary thyroid carcinoma with lymphocytic thyroiditis (PTC-LT and conventional papillary thyroid carcinoma without lymphocytic thyroiditis (PTC regarding infiltrating inflammatory cells and their distribution. Preoperative diagnosis or potential for WLV-PTC will be helpful for surgeons to decide the scope of operation. Methods Of the 8,179 patients treated for papillary thyroid carcinoma between January 2007 and December 2012, 16 patients (0.2% were pathologically confirmed as WLV-PTC and four cases were available for cytologic review. For comparison, we randomly selected six PTC-LT cases and five PTC cases during the same period. The number of intratumoral and background lymphocytes, histiocytes, neutrophils, and the presence of giant cells were evaluated and compared using conventional smear and ThinPrep preparations. Results WLV-PTC showed extensive lymphocytic smear with incorporation of thyroid follicular tumor cell clusters and frequent histiocytes. WLV-PTC was associated with higher intratumoral and background lymphocytes and histiocytes compared with PTC-LT or PTC. The difference was more distinct in liquid-based cytology. Conclusions The lymphocytic smear pattern and the number of inflammatory cells of WLV-PTC are different from those of PTC-LT or PTC and will be helpful for the differential diagnosis of WLV-PTC in preoperative FNA.

MRI diagnosis and preoperative evaluation for hepatic hilar tumor

International Nuclear Information System (INIS)

Liu Yulin; Kong xiangquan; Xu Haibo; Xiao Xuehong; Liu Dingxi; Peng Zhenjun

2004-01-01

Objective: To investigate the value of the all-in-one MR scanning in the diagnosis and preoperative evaluation of hepatic hilar tumor. Methods: Forty-two cases of hepatic hilar tumors were examined with a 1.5 T superconductive MR system, including hepatocellular carcinoma (HCC, n=12), hilar cholangiocarcinoma (HC, n=22), and hilar metastasis (n=8). Besides the precontrast MRI and MRCP, all cases underwent consecutive dynamic contrast-enhanced MR scanning. The whole liver dynamic contrast-enhanced MR was performed with the first bolus injection of Gd-DTPA (10 ml), and 15 minutes later, 3D DCE MRA was performed with additional injection of Gd-DTPA (15-20 ml) (0.15-0.20 mmol/kg). The contrast time-signal curve of liver and tumor was drawn, and arterial and portal venous phase images were reconstructed with MIP. MR appearances were compared with surgical findings and pathology. Results: Consecutive DCE scanning was successfully performed in all cases. The contrast time-signal curve of HCC showed type I and II (10/12, 83.3%), and the curve of HC showed type III and IV (21/22, 95.4%), whereas the curve of metastasis was various. The difference of tumor peak transit time (PT) between HCC group and HC group was significant (P<0.05). The vascular invasion in HCC group appeared as arterial-portal vein fistula (2/12, 16.7%), portal vein infiltration (3/24, 12.5%), and occlusion by tumor thrombosis (4/24, 16.7%). However, the vascular invasion in HC group showed spiral artery (5/22, 22.7%), portal vein infiltration (5/44, 11.4%), portal vein central narrowing (8/44, 18.2%) and occlusion (11/44, 25.0%). All metastasis had no vascular invasion expect one gall bladder carcinoma with right portal vein infiltration. The accuracy of preoperative evaluation with MRI in HCC group and HC group was 83.3% (10/12) and 86.4% (19/22), respectively. The accuracy of preoperative evaluation in all hilar tumors was 78.6% (33/42). Conclusion: Consecutive DCE was a safe and useful technique in MR

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...

Preoperative diagnosis of hydatid cyst of the breast: a case report

African Journals Online (AJOL)

abp

2013-03-12

Mar 12, 2013 ... Preoperative diagnosis of hydatid cyst of the breast: a case report. Ali Alamer1,& ... of cases have been diagnosed post-operatively with no complete radiology workup. ... It׳s challenging to differentiate it from other tumors. Only few ... in the bone, 1.5% in spleen, 1% in the muscle, and 0.5% in brain. [2].

A COMPARATIVE STUDY OF PREOPERATIVE DIAGNOSIS AND PATHOLOGICAL DIAGNOSIS IN ADRENAL SWELLINGS

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Saju P. R

2017-05-01

Full Text Available BACKGROUND The adrenal gland neoplasms include primary and metastatic malignant tumours. They can be functional or non-functional and also detected as incidentaloma lesions. Advanced imaging often reveals adrenal tumours and tumour-like conditions in both symptomatic and asymptomatic patients. Even with the functional study and advanced imaging, preoperative diagnosis is always challenging. MATERIALS AND METHODS A retrospective study of adrenal tumours performed during July 2014-April 2016 was done. Total 7 cases were included. Case records and histopathology reports were reviewed to collect data. RESULTS Majority were females (85% with mean age of 50 years. 71% patients presented symptomatically and incidentaloma was noticed in 29%. Functional tumours were found in 71%. 42% discrepancy were noted between the radiological and final histopathological findings. 28% noted in benign lesions and 14% in malignant conditions. CONCLUSION In the current era, even though imaging can aid in diagnosis, histopathology still remains as gold standard investigation in adrenal tumours.

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.

Carcinoma of the pancreas and periampullary region: palliation versus cure

NARCIS (Netherlands)

Klinkenbijl, J. H.; Jeekel, J.; Schmitz, P. I.; Rombout, P. A.; Nix, G. A.; Bruining, H. A.; van Blankenstein, M.

1993-01-01

A retrospective study of 310 patients with carcinoma of the head of the pancreas or periampullary region was performed. Preoperative bile drainage by placement of a stent reduced the number of postoperative complications, especially bleeding (P = 0.03). The operative mortality rate was nil in

An Intra-Abdominal Desmoid Tumor, Embedded in the Pancreas, Preoperatively Diagnosed as an Extragastric Growing Gastrointestinal Stromal Tumor

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Mari Mizuno

2017-04-01

Full Text Available A 45-year-old woman was found to have a pancreatic tumor by abdominal ultrasound performed for a medical check-up. Abdominal contrast-enhanced computed tomography showed a hypovascular tumor measuring 30 mm in diameter in the pancreatic tail. Endoscopic ultrasound-guided fine needle aspiration was performed. An extragastric growing gastrointestinal stromal tumor was thereby diagnosed preoperatively, and surgical resection was planned. Laparoscopic surgery was attempted but conversion to open surgery was necessitated by extensive adhesions, and distal pancreatectomy, splenectomy, and partial gastrectomy were performed. The histological diagnosis was an intra-abdominal desmoid tumor. A desmoid tumor is a fibrous soft tissue tumor arising in the fascia and musculoaponeurotic tissues. It usually occurs in the extremities and abdominal wall, and only rarely in the abdominal cavity. We experienced a case with an intra-abdominal desmoid tumor that was histologically diagnosed after laparotomy, which had been preoperatively diagnosed as an extragastric growing gastrointestinal stromal tumor. Although rare, desmoid tumors should be considered in the differential diagnosis of intra-abdominal tumors. Herein, we report this case with a literature review.

Simultaneous Serous Cystadenoma of the Pancreas and Mucinous Cystadenoma of the Appendix

OpenAIRE

Alrefaie W; Katz MH; Easter DW; Yi ES; Weidner N; Savides TS; Moossa AR; Bouvet M

2004-01-01

CONTEXT: 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. CASE REPORT: 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 acu...

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.)

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.

Preoperative Biliary Drainage for Cancer of the Head of the Pancreas

NARCIS (Netherlands)

van der Gaag, Niels A.; Rauws, Erik A. J.; van Eijck, Casper H. J.; Bruno, Marco J.; van der Harst, Erwin; Kubben, Frank J. G. M.; Gerritsen, Josephus J. G. M.; Greve, Jan Willem; Gerhards, Michael F.; de Hingh, Ignace H. J. T.; Klinkenbijl, Jean H.; Nio, Chung Y.; de Castro, Steve M. M.; Busch, Olivier R. C.; van Gulik, Thomas M.; Bossuyt, Patrick M. M.; Gouma, Dirk J.

2010-01-01

BACKGROUND The benefits of preoperative biliary drainage, which was introduced to improve the postoperative outcome in patients with obstructive jaundice caused by a tumor of the pancreatic head, are unclear. METHODS In this multicenter, randomized trial, we compared preoperative biliary drainage

Pancreas

Science.gov (United States)

... 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 ...

Post-ERCP pancreatogastric fistula associated with an intraductal papillary-mucinous neoplasm of the pancreas – a case report and literature review

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Yasuda Yoshikazu

2005-10-01

Full Text Available Abstract Background Fistula formation has been reported in intraductal papillary-mucinous neoplasms (IPMNs with or without invasion of the adjacent organs. The presence or absence of invasion is mostly determined by postoperative histological examination rather than by preoperative work-up. Case presentation A 72 year-old Japanese woman showed remarkable dilatation of the main pancreatic duct (MPD in the distal region of the pancreas. Subsequent ERCP also showed MPD dilatation, after which the patient suffered moderate pancreatitis. A subsequent gastroscopy revealed a small ulceration that had not been observed in a gastroscopy performed 3 months prior. Mucinous discharge from the ulceration suggested it might be the orifice of a fistula connected to the MPD. En bloc resection including the distal region of the pancreas, spleen, stomach and part of the transverse colon was performed under the pre- and intraoperative diagnosis of an invasive malignant IPMN. However, histopathology revealed the lesion to be of "borderline malignancy" without apparent invasion of the stomach. Light microscopy showed inflammatory cellular infiltrates (mainly neutrophils around the pancreatogastric fistula, but there was no evidence of neoplastic epithelia lining the fistulous tract. Conclusion This case highlights that a pancreatogastric fistula can develop after acute inflammation of the pancreas in the absence of cancer invasion. Further information regarding IPMN-associated fistulae is necessary to clarify the pathogenesis, diagnosis, appropriate surgical intervention and prognosis for this disorder.

Adverse events during CT colonography for screening, diagnosis and preoperative staging of colorectal cancer: a Japanese national survey

Energy Technology Data Exchange (ETDEWEB)

Nagata, Koichi [Japanese Society of Gastrointestinal Cancer Screening, Committee for Quality Assessment of Colorectal Cancer Screening, Tokyo (Japan); Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); National Cancer Centre, Division of Screening Technology, Centre for Public Health Sciences, Tokyo (Japan); Takabayashi, Ken [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); National Cancer Centre, Division of Screening Technology, Centre for Public Health Sciences, Tokyo (Japan); Hokkaido Gastroenterology Hospital, Department of Radiology, Sapporo (Japan); Yasuda, Takaaki [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); National Cancer Centre, Division of Screening Technology, Centre for Public Health Sciences, Tokyo (Japan); Nagasaki Kamigoto Hospital, Department of Radiology, Nagasaki (Japan); Hirayama, Michiaki [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Tonan Hospital, Department of Gastroenterology, Sapporo (Japan); Endo, Shungo [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Fukushima Medical University, Department of Coloproctology, Aizu Medical Centre, Aizu-Wakamatsu, Fukushima (Japan); Nozaki, Ryoichi [Japanese Society of Gastrointestinal Cancer Screening, Committee for Quality Assessment of Colorectal Cancer Screening, Tokyo (Japan); Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Takano Hospital, Coloproctology Centre, Kumamoto (Japan); Shimada, Takenobu [Japanese Society of Gastrointestinal Cancer Screening, Committee for Quality Assessment of Colorectal Cancer Screening, Tokyo (Japan); Cancer Detection Centre of the Miyagi Cancer Society, Sendai, Miyagi (Japan); Kanazawa, Hidenori [National Cancer Centre, Division of Screening Technology, Centre for Public Health Sciences, Tokyo (Japan); Jichi Medical University, Department of Radiology, Shimotsuke, Tochigi (Japan); Fujiwara, Masanori [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Kameda Medical Centre Makuhari, Radiology Section, Mihama-ku, Chiba (Japan); Shimizu, Norihito [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Matsuoka Clinic, Radiology Section, Nara (Japan); Iwatsuki, Tatema [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Matsuda Hospital, Radiology Section, Hamamatsu, Shizuoka (Japan); Iwano, Teruaki [Gastrointestinal Advanced Imaging Academy, Tochigi (Japan); Tokushima Kensei Hospital, Radiology Section, Tokushima (Japan); Saito, Hiroshi [Japanese Society of Gastrointestinal Cancer Screening, Committee for Quality Assessment of Colorectal Cancer Screening, Tokyo (Japan); National Cancer Centre, Division of Screening Assessment and Management, Centre for Public Health Sciences, Tokyo (Japan)

2017-12-15

To retrospectively evaluate the frequencies and magnitudes of adverse events associated with computed tomographic colonography (CTC) for screening, diagnosis and preoperative staging of colorectal cancer. A Japanese national survey on CTC was administered by use of an online survey tool in the form of a questionnaire. The questions covered mortality, colorectal perforation, vasovagal reaction, total number of examinations, and examination procedures. The survey data was collated and raw frequencies were determined. Fisher's exact test was used to determine differences in event rates between groups. At 431 institutions, 147,439 CTC examinations were performed. No deaths were reported. Colorectal perforations occurred in 0.014% (21/147,439): 0.003% (1/29,823) in screening, 0.014% (13/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging. The perforation risk was significantly lower in screening than in preoperative staging CTC procedures (p = 0.028). Eighty-one per cent of perforation cases (17/21) did not require emergency surgery. Vasovagal reaction occurred in 0.081% (120/147,439): 0.111% (33/29,823) in screening, 0.088% (80/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging. The risk of colorectal perforation and vasovagal reaction in CTC is low. The frequency of colorectal perforation associated with CTC is least in the screening group and greatest in the preoperative-staging group. (orig.)

Adverse events during CT colonography for screening, diagnosis and preoperative staging of colorectal cancer: a Japanese national survey

International Nuclear Information System (INIS)

Nagata, Koichi; Takabayashi, Ken; Yasuda, Takaaki; Hirayama, Michiaki; Endo, Shungo; Nozaki, Ryoichi; Shimada, Takenobu; Kanazawa, Hidenori; Fujiwara, Masanori; Shimizu, Norihito; Iwatsuki, Tatema; Iwano, Teruaki; Saito, Hiroshi

2017-01-01

To retrospectively evaluate the frequencies and magnitudes of adverse events associated with computed tomographic colonography (CTC) for screening, diagnosis and preoperative staging of colorectal cancer. A Japanese national survey on CTC was administered by use of an online survey tool in the form of a questionnaire. The questions covered mortality, colorectal perforation, vasovagal reaction, total number of examinations, and examination procedures. The survey data was collated and raw frequencies were determined. Fisher's exact test was used to determine differences in event rates between groups. At 431 institutions, 147,439 CTC examinations were performed. No deaths were reported. Colorectal perforations occurred in 0.014% (21/147,439): 0.003% (1/29,823) in screening, 0.014% (13/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging. The perforation risk was significantly lower in screening than in preoperative staging CTC procedures (p = 0.028). Eighty-one per cent of perforation cases (17/21) did not require emergency surgery. Vasovagal reaction occurred in 0.081% (120/147,439): 0.111% (33/29,823) in screening, 0.088% (80/91,007) in diagnosis and 0.028% (7/25,330) in preoperative staging. The risk of colorectal perforation and vasovagal reaction in CTC is low. The frequency of colorectal perforation associated with CTC is least in the screening group and greatest in the preoperative-staging group. (orig.)

Surgical treatment of pancreas divisum causing chronic pancreatitis: the outcome benefits of duodenum-preserving pancreatic head resection.

Science.gov (United States)

Schlosser, W; Rau, B M; Poch, B; Beger, H G

2005-01-01

Pancreas divisum (PD) represents a duct anomaly in the pancreatic head ducts, leading frequently leading to recurrent acute pancreatitis (rAP) or chronic pancreatitis (CP). Based on endoscopic retrograde cholangiopancreatography, pancreas divisum can be found in 1% to 6% of patients with pancreatitis. The correlation of this abnormality with pancreatic disease is an issue of continuing controversy. Because of the underlying duct anomalies and major pathomorphological changes in the pancreatic head, duodenum-preserving pancreatic head resection (DPPHR) offers an option for causal treatment. Thirty-six patients with pancreatitis caused by PD were treated surgically. Thirty patients suffered from CP, 6 from rAP. The mean duration of the disease was 47.5 and 49.8 months, respectively. The age at the time of surgery was 39.2 years in the CP group, and 27.6 years in the rAP group. Median hospitalization since diagnosis was 18.8 weeks for CP patients and 24.6 weeks for rAP patients. Previous procedures performed in these patients included endoscopic papillotomy (30%), duct stenting (14%), and surgical treatment (17%). The median preoperative pain score was 8 on a visual analog scale. According to the classification of pancreas divisum, 10 patients demonstrated a complete PD, 25 had a functionally incomplete PD, and 1 had a dorsal duct type. The pain status as well as the endocrine (oral glucose tolerance test) and exocrine (pancreolauryl test) function were evaluated preoperatively and early and late postoperatively with a median follow-up time of 39.3 months. There was no operative-related mortality. The follow-up was 100%; 4 patients died (1 from suicide, 1 from cardiac arrest, and 2 from cancer of the esophagus). Fifty percent of the patients were completely pain-free, 31% had a significant reduction of pain with a median pain score of 2 (P pancreatitis with a need for hospitalization. DPPHR reduced pain and preserved the endocrine function in the majority of patients

The role of volume perfusion CT in the diagnosis of pathologies of the pancreas; Die Rolle des Volumenperfusions-CT in der Diagnostik von Pankreaspathologika

Energy Technology Data Exchange (ETDEWEB)

Groezinger, G.; Groezinger, A.; Horger, M. [Universitaetsklinik Tuebingen (Germany). Abt. fuer Diagnostische und Interventionelle Radiologie

2014-12-15

The review discusses the potential role of volume perfusion CT (VPCT) in the diagnosis and follow-up of different pathologies of the pancreas. VPCT enables a differentiation of different pancreatic tumors like adenocarcinoma or neuroendocrine tumors based on functional parameters like blood flow, blood volume and permeability. Furthermore, the article discusses the potential indications for VPCT imaging of inflammatory diseases of the pancreas such as acute or chronic pancreatitis and autoimmune pancreatitis.

Functional and morphological evolution of remnant pancreas after resection for pancreatic adenocarcinoma.

Science.gov (United States)

Park, Shin-Young; Park, Keun-Myoung; Shin, Woo Young; Choe, Yun-Mee; Hur, Yoon-Seok; Lee, Keon-Young; Ahn, Seung-Ik

2017-07-01

Functional and morphological evolution of remnant pancreas after resection for pancreatic adenocarcinoma is investigated.The medical records of 45 patients who had undergone radical resection for pancreatic adenocarcinoma from March 2010 to September 2013 were reviewed retrospectively. There were 34 patients in the pancreaticoduodenectomy (PD) group and 10 patients in the distal pancreatectomy (DP) group. One patient received total pancreatectomy. The endocrine function was measured using the glucose tolerance index (GTI), which was derived by dividing daily maximum serum glucose fluctuation by daily minimum glucose. Remnant pancreas volume (RPV) was estimated by considering pancreas body and tail as a column, and head as an ellipsoid, respectively. The pancreatic atrophic index (PAI) was defined as the ratio of pancreatic duct width to total pancreas width. Representative indices of each patient were compared before and after resection up to 2 years postoperatively.The area under receiver operating characteristic curve of GTI for diagnosing DM was 0.823 (95% confidence interval, 0.699-0.948, P < .001). Overall, GTI increased on postoperative day 1 (POD#1, mean ± standard deviation, 1.79 ± 1.40 vs preoperative, 1.02 ± 1.41; P = .001), and then decreased by day 7 (0.89 ± 1.16 vs POD#1, P < .001). In the PD group, the GTI on POD#14 became lower than preoperative (0.51 ± 0.38 vs 0.96 ± 1.37; P = .03). PAI in the PD group was significantly lower at 1 month postoperatively (0.22 ± 0.12 vs preoperative, 0.38 ± 0.18; P < .001). In the PD group, RPV was significantly lower at 1 month postoperatively (25.3 ± 18.3 cm vs preoperative, 32.4 ± 20.1 cm; P = .02), due to the resolution of pancreatic duct dilatation. RPV of the DP group showed no significant change. GTI was negatively related to RPV preoperatively (r = -0.317, P = .04), but this correlation disappeared postoperatively (r = -0

Adenocarcinoma of the pancreatic head: preoperative helical CT. Criteria of resectability

International Nuclear Information System (INIS)

Kozima, Shigeru; Szelagowski, Carlos; Tisserand, Guy L.; Ocampo, Carlos; Zandalazini, Hugo; Silva, Walter; Oria, Alejandro; Vidovic, Gustavo; Varas, Pablo

2001-01-01

Objective: The purpose of this study is to determine the accuracy of biphasic helical CT scanning in predicting resectability of adenocarcinoma of the head of the pancreas by staying tumor involvement of the portal and superior mesenteric veins. Material and methods: 46 patients with proven adenocarcinoma of the head of the pancreas who underwent curative or palliative surgery were studied with preoperative biphasic helical CT scanning. Tumor involvement of the portal and mesenteric veins was graduated on a 1-3 scale based on circumferential contiguity of the tumor vessel. Grade 1: without contact; grade 2: tumor involvement of less than 50% of the vessel; grade 3: tumor involvement of more than 50%. Results: The total number of vessels evaluated was 92. In our series the preoperative biphasic helical CT was accurate in 77% for resectability and unresectability. Conclusion: Our experience of staging in 3 grades with biphasic helical CT, vessel involvement the portal and superior mesenteric veins of adenocarcinoma of the head of the pancreas is highly specific for unresectable tumor in patients who were graded 2 and 3. (author)

Intrapancreatic Splenule in a Pancreas Allograft: Case Report.

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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.

Aneurysms of proximal pulmonary arteries: CT diagnosis and preoperative assessment

International Nuclear Information System (INIS)

Iula, G.; Ziviello, R.; Del Vecchio, W.

1996-01-01

We reviewed our experience with proximal pulmonary artery aneurysm (PPAA) to determine whether accurate preoperative evaluation (crucial to differential diagnosis and surgical planning) had been obtained on the basis of CT study alone. Three patients with PPAA were studied with contrast-enhanced CT. We evaluated the size and shape of PPAAs, their proximal and distal extent, eventual presence of intraluminal thrombi, dissection, perianeurysmal fibrosis, and rupture. The results were compared with surgical findings. In two patients the aneurysm involved the pulmonary trunk and both the right and left arteries origin. In one patient the aneurysm extended from the left artery origin to the hilum of the left lung. Contrast-enhanced CT alone allows detection of aneurysm in the pulmonary trunk, in right or left pulmonary arteries with precise preoperative evaluation of the extent, size, shape, and complications. The CT imaging was unable to establish the etiologic origin and presence of small intimal tears in PPAA. (orig.)

Metastatic Merkel Cell Carcinoma (MCC) of Pancreas.

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Kartal, K; Hamaloğlu, E

2015-01-01

Merkel cell carcinoma (MCC) is a rare, agressive, neurocutaneous malignancy with a high potential to metastasize. We present a 59 year-old woman referred to general surgery department with a complaint of epigastric pain. The abdominal computed tomography (CT) performed and revealed amass of 3 cm in the head of the pancreas. The significant debate in the patient's medical history was that she had a MCC in size of 5 cm removed from the left gluteal region 7 months ago. Following preoperative preparation a pancreatic oduodenectomy with Whipple procedure was performed fort hepancreatic head mass. As the tumor showed morphologically similar properties with the patient's primary neoplasm, it was accepted as a metastatic MCC. Following the operation the patient received adjuvant chemotherapy and at a 30 months follow-up it was observed that the patient is disease free and has no complications related to the disease progression or recurrence. Although MCC is an aggresive and poor prognostic tumor, good results can be obtained with correct diagnosis and proper surgical treatment. Celsius.

Compined preoperative diagnosis of stomach cancer involvement of the abdominal and retroperitoneal organs and tissues

International Nuclear Information System (INIS)

Fisher, M.E.; Gabuniya, R.I.; Kolesnikova, E.K.; Bal'ter, S.A.; Ostrovtsev, I.V.; Dolgushin, B.I.; Mazurov, S.T.; Mironova, G.T.

1987-01-01

An analysis of 136 cases of stomach cancer led to the determination of the role and place of gammatopography, echography, computerized X-ray tomography, angiography and laparoscopy in specified preoperative diagnosis of extraorganic spreading of primary tumors. The informative value and shortcomings of certain methods were shown. A high accuracy of the entire set of diagnostic procedures (94.8%) in the preoperative definition of stomach cancer involvement of the abdominal and retroperitoneal organs and tissues was emphasized

Imaging diagnosis of intraductal papillary mucinous tumor of the pancreas

International Nuclear Information System (INIS)

Zhang Huimao; Lai Ying; Yang Shuqin; Yang Haishan; Murakami, K.

2005-01-01

Objective: To explore the diagnostic value of intraductal papillary mucinous tumor (IPMT) of the pancreas, and to assess its clinical and characteristic radiological features. Methods: Thirty-six cases with IPMT who underwent CT and MRI with plain and contrast enhancement before operation were reviewed. The clinical presentation and characteristic imaging findings of main duct type (8 cases) and branch duct type (28 cases) were retrospectively reviewed. Results: Typical imaging findings of main duct type were segmental or diffuse dilation of MPD (diameter was over 9 mm) with enhanced mural nodules after contrast medium administration. MR cholangiopancreatography (MRCP) showed dilation of MPD with flat/nodule filling defects in 4 cases and MPD dilatation in the head side in 2 cases. Branch duct type was more frequently located in the head or uncinate. Typical imaging findings of branch duct type were unilocular or multilocular cystic tumors with septa, mural nodules, and MPD dilatation. MRCP showed septa in 24 cases, filling defects in 15 cases, and MPD dilatation in 8 cases. Communication between the cystic lesion and the MPD was demonstrated in 19 cases by MRCP. Conclusion: It is extremely important to accurately make the diagnosis of IPMT for planning the surgical strategy. MRCP is a noninvasive and useful method in detecting and making definite diagnosis of IPMT. (authors)

Endoscopic ultrasound-guided fine-needle aspiration diagnosis of secondary tumors involving the pancreas: An institution′s experience

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Ahmed K Alomari

2016-01-01

Full Text Available Background: Pancreatic masses may seldom represent a metastasis or secondary involvement by lymphoproliferative disorders. Recognition of this uncommon occurrence may help render an accurate diagnosis and avoid diagnostic pitfalls during endoscopic ultrasound-guided fine needle aspiration (EUS-FNA. In this study, we review our experience in diagnosing secondary tumors involving the pancreas. Materials and Methods: The electronic database of cytopathology archives was searched for cases of secondary tumors involving the pancreas at our institution and a total of 31 cases were identified. The corresponding clinical presentations, imaging study findings, cytological diagnoses, the results of ancillary studies, and surgical follow-up, if available, were reviewed. Results: Nineteen of the patients were male and 12 female, with a mean age of 66 years. Twenty-three patients (74% had a prior history of malignancy, with the latency ranging from 6 months to 19 years. The secondary tumors involving the pancreas included metastatic carcinoma (24 cases, metastatic sarcoma (3 cases, diffuse large B-cell lymphoma (2 cases, and plasma cell neoplasm (2 cases. The most common metastatic tumors were renal cell carcinoma (8 cases and lung carcinoma (7 cases. Correct diagnoses were rendered in 29 cases (94%. The remaining two cases were misclassified as primary pancreatic carcinoma. In both cases, the patients had no known history of malignancy, and no ancillary studies were performed. Conclusions: Secondary tumors involving the pancreas can be accurately diagnosed by EUS-FNA. Recognizing uncommon cytomorphologic features, knowing prior history of malignancy, and performing ancillary studies are the keys to improve diagnostic performance and avoid diagnostic pitfalls.

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.

Preoperative Diagnosis of Gastric Tumors by Three-dimensional Multidetector Row CT and Double Contrast Barium Meal Study: Correlation with Surgical and Histologic Results

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Bang-Bin Chen

2007-11-01

Conclusion: MDCT has a similar high accuracy in the preoperative diagnosis of different gastric tumors compared with DCBM and provides additional information including tumor depth, lymph node and hepatic metastasis. Therefore, MDCT may be used as a primary tool for preoperative tumor diagnosis and staging.

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, ...

First Report of Preoperative Imaging Diagnosis of a Surgically Confirmed Case of Valentino′s Syndrome

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Parag Suresh Mahajan

2014-01-01

Full Text Available Perforation of a duodenal ulcer (DU into the retroperitoneal space presenting with clinical features of acute appendicitis is known as Valentino′s syndrome. Post duodenal perforation, the gastric and duodenal fluids tend to settle in the right paracolic gutter causing peritonitis and clinically mimicking acute appendicitis. Only three cases of Valentino′s syndrome have been reported till date in the published literature and there is only one previous report of its preoperative imaging diagnosis. To our knowledge, this is the first reported case of preoperative imaging diagnosis in a surgically confirmed case of Valentino′s syndrome. In most cases, patients with undiagnosed Valentino′s syndrome are operated for acute appendicitis, and on finding a normal appendix, search is made for the cause of peritonitis, which then leads to retroperitoneal perforation of duodenum. The diagnosis of Valentino′s syndrome by computed tomography (CT imaging is easy and can help in avoiding the surgery or directing the surgeon directly to the repair of the duodenal perforation. It is, therefore, essential for emergency physicians, surgeons, and radiologists to know about this entity and consider it in the differential diagnosis.

SOLID PSEUDOPAPILLARY TUMOUR OF THE PANCREAS: A TERTIARY CARE CENTRE EXPERIENCE

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Lingam Aruna

2016-08-01

Full Text Available BACKGROUND Solid pseudopapillary tumour of the pancreas is a rare tumour of low malignant potential occurring predominantly in young females. Its incidence has been increasing due to advanced imaging modalities. As this tumour offers a good prognosis, it is important to make a proper diagnosis to offer better treatment and reduce morbidity. MATERIALS AND METHODS This is a prospective study for a period of 2 years (From May 2014 to April 2016. Of the 52 pancreatic specimens we received after surgery, 9 cases had a prior radiological diagnosis of solid pseudopapillary tumour of the pancreas. The clinical and histopathological characteristics of SPT were studied along with review of literature. Whipple resection specimens which were radiologically diagnosed as adenocarcinoma of the periampullary region were excluded. RESULTS Nine cases were reported radiologically as papillary neoplasm of pancreas. On histopathology, 8 of them were confirmed as solid pseudopapillary tumours of the pancreas. One was a case of serous cystadenoma and other one was pancreatic neuroendocrine tumour. One case which was suspected as pancreatic endocrine tumour radiologically was diagnosed as SPT. CONCLUSION SPT typically is limited to the pancreas at the time of diagnosis, and even with metastasis, an extended complete surgical excision offers good prognosis. Hence, it is important to distinguish it from other tumours of similar morphology. In this study, we discuss the process of establishing the diagnosis accurately of SPN in young patients presenting with pancreatic mass.

Metastatic Renal Cell Carcinoma to the Pancreas: A Review.

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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.

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

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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.

Serous Cystadenoma of the Pancreas Presenting as a Third Primary Neoplasm

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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.

The clinical significance of CT in the preoperative diagnosis of colon and rectal cancer

International Nuclear Information System (INIS)

Itano, Satoshi; Fuchimoto, Sadanori; Hamada, Fumihiro; Kimura, Takanobu; Orita, Kunzo

1986-01-01

The clinical significance of CT in the preoperative diagnosis of colon and rectal cancer was studied. Thirty four patients were investigated in this series. The diagnostic criteria of the CT examination were previously established in a study of wall invasion (S factor), lymph node metastasis (N factor), liver metastasis (H factor) and peritoneal dissemination (P factor). The CT diagnosis was done prospectively according to these criteria, and the CT diagnosis was compared with the macroscopic and histological diagnosis. The accuracy of the prospective diagnosis as to H, S, N and P factors was 79.4 %, 55.9 %, 41.2 % and 20.6 %, respectively. The diagnostic value of CT seemed to be acceptable as to the H factor, but limited to some extent to the S and N factors. (author)

Contribution of a multiplex serological test for the preoperative diagnosis of prosthetic joint infection: a prospective study.

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de Seynes, Camille; de Barbeyrac, Bertille; Dutronc, Hervé; Ribes, Clément; Crémer, Paul; Dubois, Véronique; Fabre, Thierry; Dupon, Michel; Dauchy, Frédéric-Antoine

2018-03-22

Prosthetic joint infection (PJI) is a severe complication of orthopaedic surgery. Preoperative diagnosis, although sometimes difficult, is key to choose the relevant treatment. We conducted a prospective study aimed at evaluating the diagnostic performance of a multiplex serological test for the pre-operative diagnosis of PJI. Blood samples were collected between 1 July 2016 and 31 July 2017 among patients referred for suspected PJI that occurred at least six weeks prior. Infection diagnosis was confirmed using intraoperative bacteriological cultures during prosthetic exchange. Seventy-one patients were included, with a median age of 73 years (interquartile range [IQR]: 66-81) and 40 (56%) were male. Twenty-six patients had aseptic loosening and 45 patients had PJI. Among the latter, median time since the last surgery was 96 weeks (IQR: 20-324). Intraoperative cultures found Staphylococcus spp, Streptococcus spp or both in 39, 5 and 1 patients, respectively. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 81.8, 95.4, 97.3 and 72.4%, respectively, for all patients and 87.5, 93.5, 94.6 and 85.3%, respectively, for staphylococcal infections. Patients with false negative (FN) results had a significantly lower blood lymphocyte count (p = .045). Multiplex serological test performed well among patients with chronic staphylococcal prosthetic infection. This approach could contribute to PJI diagnosis especially in patients for whom the pre-operative analysis of joint fluid is not informative.

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)

Specific preoperative diagnosis of choledochal cysts by combined sonography and hepatobiliary scintigraphy

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Papanicolaou, N.; Abramson, S.J.; Teele, R.L.; Treves, S.

1985-01-01

The combined use of sonography and hepatobiliary scintigraphy correctly identified a choledochal cyst preoperatively in seven consecutive infants and children. The high resolution anatomic images provided by sonography coupled with physiologic data on filing of the cyst, biliary patency and liver function derived from radionuclide scanning offer valuable information in the diagnosis and planning of corrective surgery of the cyst and coexisting hepatobiliary anomalies. Invasive diagnostic procedures should be reserved for occasional problematic cases [fr

Getting a New Pancreas: Facts about Pancreas Transplants

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... 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 ...

Endoscopic Ultrasound in Endocrinology: Imaging of the Adrenals and the Endocrine Pancreas.

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Kann, Peter Herbert

2016-01-01

Endoscopic ultrasound (EUS) imaging of adrenal glands and its application to diagnostic procedures of adrenal diseases has been reported since 1998. It can be considered a relevant advantage in the field of adrenal diseases. Indeed, EUS allows the detection of adrenal lesions (even very small ones) and their characterization, the assessment of malignancy criteria, the early detection of neoplastic recurrences, the preoperative identification of morphologically healthy parts of the glands, the differentiation of extra-adrenal from adrenal tumors, and of the pathological entities associated with adrenal insufficiency, and the fine-needle aspiration biopsy (EUS-FNA) of suspicious lesions. At the same time, its clinical relevance depends on the experience of the endosonographer. Moreover, EUS is also by far the best and most sensitive imaging technique to detect and assess the follow-up of pancreatic manifestation of MEN1 disease. It furthermore enables the preoperatively localization of insulinomas and critical structures in their neighborhood, and may be relevant in planning surgical strategy. A positive EUS in a case of insulinoma furthermore confirms the endocrine diagnosis, especially considering the differential diagnosis of hypoglycemia factitia by oral antidiabetics. It can be supplemented by EUS-FNA. Again, it has to be considered that EUS may reveal false positive and false negative results, and the quality of the findings largely depends on the endosonographer's skills and experience. The most important technical details together with the advantages and limitations of EUS, and the pathognomonic characteristic of benign and malignant disorders of the adrenals and pancreas are presented here. © 2016 S. Karger AG, Basel.

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

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

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.

Preoperative diagnosis and surgical strategy in congenital auditory ossicular malformation of 26 ears

International Nuclear Information System (INIS)

Kanazawa, Yuji; Naito, Yasushi; Shinohara, Shogo; Fujiwara, Keizo; Kikuchi, Masahiro; Yamazaki, Hiroshi; Kurihara, Risa; Kishimoto, Ippei

2012-01-01

We retrospectively analyzed 26 ears of 21 subjects having auditory ossicular malformation and who had undergone auditory reconstruction between April 2004 and December 2010 at our clinic. We checked preoperative condition, pathological classification, surgical procedure, and hearing improvement. We could predict pathological conditions precisely from preoperative computed tomography (CT), including incudostapedial disconnection (9/12, 75%) and malleus and/or incus fixation (7/12, 58%), which tended to be present in external ear malformation, and stapes footplate fixation (0/12, 0%). We could not, however, predict complex malformation (0/8, 0%). Overall success was 90% (18/20) in the 20 ears observed for at least 1 year. In the 2 ears without improved hearing, the first had congenital cholesteatoma and no stapes superstructure, was treated with type IV tympanoplasty. The second had malleus, incus, and stapes fixation and discontinuity between the incus and stapes, and was treated with type III tympanoplasty and stapes mobilization. Preoperative diagnosis is difficult in mixed congenital auditory ossicular malformation, especially stapes footplate fixation, possibly requiring unexpected procedures, with a poor hearing outcome. Preoperative status must thus be evaluated precisely using hearing, tympanometry, acoustic reflex test, and CT. Temporal bone CT and external ear findings are useful in diagnosing middle-ear malformation. Subjects' informed consent should also be obtained due to the possible need for changing procedure based on findings during surgery. (author)

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

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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.

Laparoscopic treatment of heterotopic pancreas in the prepyloric region

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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.

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.)

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

Differential diagnosis of benign and malignant intraductal papillary mucinous tumors of the pancreas: MR cholangiopancreatography and MR angiography

International Nuclear Information System (INIS)

Choi, Byung Se; Kim, Tae Kyoung; Kim, Ah Young; Kim, Kyoung Won; Park, Sung Won; Kim, Pyo Nyun; Ha, Kyun Kwon; Lee, Moon Gyu; Kim, Song Cheol

2003-01-01

To compare the usefulness of magnetic resonance cholangiopancreatography (MRCP) and MR angiography (MRA) in differentiating malignant from benign intraductal papillary mucinous tumors of the pancreas (IPMTs), and to determine the findings which suggest malignancy. During a 6-year period, 46 patients with IPMT underwent MRCP. Morphologically, tumor type was classified as main duct, branch duct, or combined. The diameter of the main pancreatic duct (MPD), the extent of the dilated MPD, and the location and size of the cystic lesion, septum, and communicating channel were assessed. For all types of IPMTs, enhanced mural nodules and portal vein narrowing were evaluated at MRA. Combined-type IPMTs were more frequently malignant (78%) than benign (42%) (p<0.05). Compared with benign lesions, malignant lesions were larger, and the caliber of the communicating channel was also larger (p < 0.05). Their dilated MPD was more extensive and of greater diameter (p<0.05), and the presence of mural nodules was more frequent (p<0.001). Combined MRCP and MRA might be useful for the differential diagnosis of malignant and benign IPMTs of the pancreas

Functioning islet cell tumor of the pancreas. Localization with dynamic spiral CT

International Nuclear Information System (INIS)

Chung, M.J.; Choi, B.I.; Han, J.K.; Chung, J.W.; Han, M.C.; Bae, S.H.

1997-01-01

Purpose: The purpose of this study was to evaluate the usefulness of dynamic spiral CT, including multidimensional reformation, in the detection and localization of islet cell tumors of the pancreas. Material and Methods: Seven patients with histopathologically proven functioning islet cell tumors of the pancreas were studied with 2-phase contrast-enhanced spiral CT. Scanning of the arterial phase and late phase was started 30 s and 180 s, respectively, after injection of 100 ml of contrast medium at a rate of 3 ml/s. Results: Axial images in the arterial phase depicted the lesions in 5 patients, but in the late phase in only one patient. Multiplanar reformatted images of the arterial phase depicted the lesions in all 7 patients. Maximal intensity projection images demonstrated all lesions with information of their relationship to the vascular structure. Conclusion: Dynamic spiral CT with scanning during the arterial phase and retrospective multidimensional reformation is useful for preoperative detection and localization of small islet cell tumors of the pancreas. (orig.)

Acinar cell carcinoma of the pancreas presenting as diffuse pancreatic enlargement: Two case reports and literature review.

Science.gov (United States)

Luo, Yaping; Hu, Guilan; Ma, Yanru; Guo, Ning; Li, Fang

2017-09-01

Pancreatic acinar cell carcinoma (ACC) is a rare malignant tumor of exocrine pancreas. It is typically a well-marginated large solid mass arising in a certain aspect of the pancreas. Diffuse involvement of ACC in the pancreas is very rare, and may simulate pancreatitis in radiological findings. We report 2 cases of ACC presenting as diffuse enlargement of the pancreas due to tumor involvement without formation of a distinct mass. The patients consisted of a 41-year-old man with weight loss and a 77-year-old man who was asymptomatic. Computed tomography (CT) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT showed diffuse enlargement of the pancreas forming a sausage-like shape with homogenously increased FDG activity. Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) biopsy of the pancreatic lesion was performed. Histopathology results from the pancreas confirmed the diagnosis of pancreatic ACC. Because diffuse enlargement of the pancreas is a common imaging feature of pancreatitis, recognition of this rare morphologic pattern of ACC is important for radiological diagnosis of this tumor.

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.

Clinical significance of magnetic resonance cholangiopancreatography for the diagnosis of cystic tumor of the pancreas compared with endoscopic retrograde cholangiopancreatography and computed tomography

International Nuclear Information System (INIS)

Mera, Kiyomi; Tajiri, Hisao; Muto, Manabu

1999-01-01

Cystic tumor of the pancreas has been investigated by a variety of imaging techniques. Magnetic resonance cholangiopancreatography (MRCP) is being widely used as a non-invasive diagnostic modality for investigation of the biliary tree and pancreatic duct system. The purpose of this study was to compare MRCP images with those of endoscopic retrograde cholangiopancreatography (ERCP) and computed tomography (CT) in order to clarify the diagnostic efficacy of MRCP for cystic tumor of the pancreas. We retrospectively studied 15 patients with cystic tumor of the pancreas that had been surgically resected and histopathologically confirmed. There were five cases of intraductal papillary adenocarcinoma, five of intraductal papillary adenoma, two of serous cyst adenoma, two of retention cyst associated with invasive ductal adenocarcinoma and one of solid cystic tumor. In all cases MRCP correctly identified the main pancreatic duct (MPD) and showed the entire cystic tumor and the communication between the tumor and the MPD. On the other hand, the detection rate by ERCP of the cystic tumor and the communication between the cystic tumor and the MPD was only 60%. Although the detection rates by CT for the septum and solid components inside the cystic tumor were 100 and 90.0%, respectively, those of MRCP for each were 58.3 and 20.0%. MRCP is capable of providing diagnostic information superior to ERCP for the diagnosis of cystic tumor of the pancreas. Although MRCP may provide complementary information about the whole lesion of interest, the characteristic internal features of cystic tumor of the pancreas should be carefully diagnosed in combination with CT. (author)

MR imaging in pancreas head cancer

International Nuclear Information System (INIS)

Yokota, Hajime; Yamanouchi, Baisetsu; Takarada, Akira; Tonami, Hisao; Okimura, Tetsuro; Miyamura, Toshio; Yamamoto, Itaru; Kinami, Yoshio

1989-01-01

To reduce artifacts associated with MRI, we used abdominal belts and anticholinergic during the examinations in patients with pancreas head cancer. In selected cases, foric pyrophosphate was injected into the common bile duct as a contrast medium. We made a comparative study of the results of MRI with those of CT with regard to lesion detectability and diagnostic ability of tumor invasion. MR examinations were performed at 0.5 Tesla superconducting unit using spin-echo (SE) pulse sequences. Eleven patients with pancreas head cancer were enrolled in this study. As to the lesion detectability, eight cases (73%) were detected clearly or moderately clearly on MRI, almost corresponding to 9 cases (82%) on CT. With regard to the neoplastic infiltration to the surrounding area, MRI and CT were almost equally efficient as to the capsular and the arterial invasion. However, as to the invasion to the posterion surface of pancreas and the portal system, MRI was a little superior to CT. In patients to whom foric pyrophosphate was injected, the choledochal duct was clearly separated from the tumor. In conclusion, our results suggest that MRI using abdominal belts, anticholinergic and foric pyrophosphate solution is extremely effective in the diagnosis of pancreas head cancer and is almost as efficient as CT. (author)

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 ...

Computed tomography in pancreas cancer

International Nuclear Information System (INIS)

Fujita, Nobuyuki; Matsuoka, Yoshisuke; Choji, Kiyoshi; Mizuo, Hideyo; Shinohara, Masahiro; Morita, Yutaka; Irie, Goro

1985-01-01

We reviewed CT pictures of 31 cases of pancreas cancer to examine detectability of vascular involvement. To demonstrate vascular abnormalities distinctly, we performed bolus injection of contrast medium, followed by drip infusion. The vessels included in this study were portal vein, superior mesenteric vein, and splenic vein. We concluded as below, 1) CT is valuable tool for detection of the vascular abnormality, and can demonstrate vascular involvement distinctly in a case of pancreas cancer. 2) The detectability of the vascular abnormality was correlated well with the result of angiography. 3) The differentiation between stenosis and obstruction was thought to be impossible only with the local vascular changes. But with an information of the collateral pathway, the diagnosis of obstruction was possible. CT can demonstrate these collaterals in 7 of 8 cases. (author)

Epidemiology, Diagnosis, and Management of Cystic Lesions of the Pancreas

NARCIS (Netherlands)

de Jong, Koen; Bruno, Marco J.; Fockens, Paul

2012-01-01

Although little is known on the true prevalence of pancreatic cysts, physicians are currently more frequently confronted with pancreatic cysts because of the increasing use of sophisticated cross-sectional abdominal imaging. Cystic lesions of the pancreas comprise of a heterogeneous group of

Breast Carcinoma With Unrecognized Neuroendocrine Differentiation Metastasizing to the Pancreas

DEFF Research Database (Denmark)

Christensen, Lene Svendstrup; Mortensen, Michael Bau; Detlefsen, Sönke

2016-01-01

, a second panel revealed positivity for estrogen receptors and GATA3. On review of the lumpectomy specimen, a significant neuroendocrine component was found, leading to the final diagnosis of breast carcinoma with neuroendocrine features metastasizing to the pancreas. Neuroendocrine markers...... are not routinely analyzed in breast tumors. Hence, metastases from breast carcinomas with unrecognized neuroendocrine features may lead to false diagnoses of primary neuroendocrine tumors at different metastatic sites, such as the pancreas....

What Is the Pancreas?

Science.gov (United States)

... 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. ...

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

NARCIS (Netherlands)

N.A. van der Gaag (Niels); S.M.M. de Castro (Steve); E.A.J. Rauws (Erik); M.J. Bruno (Marco); C.H.J. van Eijck (Casper); E.J. Kuipers (Ernst); J.J.G.M. Gerritsen (Josephus); J.P. Rutten (Joost Paul); J.W. Greve; E.J. Hesselink (Eric); J.H. Klinkenbijl (Jean); I.H.M.B. Rinkes; D. Boerma (Djamila); B.A. Bonsing (Bert); C.J. van Laarhoven (Cees); F.J. Kubben; E. van der Harst (Erwin); M.N. Sosef (Meindert); K. Bosscha (Koop); I.H.J.T. de Hingh (Ignace); L. Th de Wit (Laurens); O.M. van Delden (Otto); O.R.C. Busch (Olivier); T.M. van Gulik (Thomas); P.M.M. Bossuyt (Patrick); D.J. Gouma (Dirk)

2007-01-01

textabstractBackground. Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct) tumor is associated with a higher risk of postoperative complications than in non-jaundiced patients. Preoperative biliary drainage was introduced in an attempt to

Magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum: a systematic review and meta-analysis.

Science.gov (United States)

Rustagi, Tarun; Njei, Basile

2014-08-01

This study aimed to perform a structured meta-analysis of all eligible studies to assess the overall diagnostic use of magnetic resonance cholangiopancreatography (MRCP) alone or with secretin enhancement (secretin-enhanced MRCP [S-MRCP]) in the detection of pancreas divisum. Two authors independently performed a comprehensive search of PubMed, MEDLINE, and the Cochrane Library from inception to September 2013. Studies were included if they allowed construction of 2 × 2 contingency tables of MRCP and/or S-MRCP compared with criterion standard. DerSimonian-Laird random effect models were used to estimate the pooled sensitivity, specificity, specificity, and quantitative receiver operating characteristics. Of 51 citations, 10 studies with 1474 patients were included. Secretin-enhanced MRCP had a higher overall diagnostic performance than MRCP (S-MRCP: pooled sensitivity, 86% [95% confidence interval (CI), 77%-93%]; specificity, 97% [95% CI, 94%-99%]; and area under the curve, 0.93 ± 0.056 compared with MRCP: sensitivity, 52% [95% CI, 45%-59%]; specificity, 97% [95% CI, 94%-99%]; and area under the curve, 0.76 ± 0.104). Pooled diagnostic odds ratios were 72.19 (95% CI, 5.66-938.8) and 23.39 (95% CI, 7.93-69.02) for S-MRCP and MRCP, respectively. Visual inspection of the funnel plot showed low potential for publication bias. Secretin-enhanced MRCP has a much higher diagnostic accuracy than MRCP and should be preferred for diagnosis of pancreas divisum.

[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

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

NARCIS (Netherlands)

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

2007-01-01

BACKGROUND: Surgery in patients with obstructive jaundice caused by a periampullary (pancreas, papilla, distal bile duct) tumor is associated with a higher risk of postoperative complications than in non-jaundiced patients. Preoperative biliary drainage was introduced in an attempt to improve the

Possibilities traditional and liquid-based cytology combined with immunocytochemical detection of some molecular markers in the preoperative diagnosis of well-differentiated thyroid cancer

Directory of Open Access Journals (Sweden)

Irina S. Berjozkina

2016-05-01

Conclusion. The diagnostic accuracy of the method of liquid-based cytology is higher than the traditional method of cytology. ICC expression of Ki-67 method has 81.8% of sensitivity and 100% of specificity for the preoperative diagnosis of thyroid cancer. Conjoint definition HS Ki-67 and liquid-based cytology increases the sensitivity and specificity of the diagnosis of well-differentiated thyroid cancer preoperative to 100%. There no detected relations between the expression of galectin-3, NFM, Ki-67 and the presence an autoimmune process in the thyroid.

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

Value of preoperative serum LC3 and MMPs combined with TSH detection in diagnosis of papillary thyroid carcinoma

Directory of Open Access Journals (Sweden)

Yan-Fei Lu

2016-03-01

Full Text Available Objective: To study the value of preoperative serum LC3 and MMPs combined with TSH detection in diagnosis of papillary thyroid carcinoma and provide reference for clinical diagnosis and treatment. Methods: A total of 80 cases of patients with papillary thyroid carcinoma treated in our hospital from March 2010 to March 2014 were analyzed, and serum TSH, MMP2/9, TIMP1/2 and LC3 levels of patients before operation were detected by ELISA. Healthy subjects and patients with benign neoplasm of thyroid during the same period were taken as control. Results: Serum TSH, MMP2, MMP9 and LC3 levels in patients with papillary thyroid carcinoma significantly increased, TIMP1 and TIMP2 levels significantly decreased, and compared with healthy subjects and patients with benign neoplasm of thyroid, there were significant statistical differences; at the same time, above parameters in serum were not related to gender, but closely related to age, clinical stage and diameter of tumor as well as lymph node. Conclusion: Preoperative detection of serum LC3 and MMPs combined with TSH levels has important reference significance in diagnosis of papillary thyroid carcinoma.

Fibromyxoid sarcoma of the pancreas

Directory of Open Access Journals (Sweden)

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. .

Preoperative diagnosis of N-factor by MR in primary lung cancer

International Nuclear Information System (INIS)

Akata, Soichi; Amino, Saburo; Abe, Kimihiko

1993-01-01

We compared the accuracies of preoperative diagnosis of N-factor by CT and MR in 71 cases of primary lung cancer. Lymph nodes larger than 10 mm in diameter were defined as positive. As a result, CT and MR both achieved an accuracy of more than 80%. MR was inefficient in detecting calcification and showed lower spatial resolution than CT; however, MR was useful in detecting hilar lymph nodes because of the signal loss of blood vessels. MR should be used to detect the contralateral hilar lymph nodes swelling because the sensitivity in the hilus is 20% higher in MR than in CT and the information about the contralateral hilar lymph nodes is more important than ipsilateral hilar lymph nodes for operation. (author)

Value of pelvic MRI in the preoperative diagnosis of endometriosis; Wertigkeit der Magnetresonanztomographie (MRT) des Beckens in der praeoperativen Diagnostik der Endometriose

Energy Technology Data Exchange (ETDEWEB)

Hauth, E.A.M.; Antoch, G.; Ruehm, S.G.; Forsting, M. [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Boeing, C.; Kimmig, R. [Universitaetsklinikum Essen (Germany). Klinik fuer Frauenheilkunde und Geburtshilfe

2004-09-01

Purpose: To determine the value of magnetic resonance imaging (MRI) of the pelvis in the preoperative diagnosis of endometriosis. Materials and Methods: Over a period of 8 months, preoperative MRI of the pelvis were obtained in 13 patients with suspected endometriosis (mean patient age 34.6 years; range 25-47 years). Results: In 9 of 13 patients (69%), the diagnosis of endometriosis was made by MRI and confirmed by laparoscopy in 8 cases. In 2 of 13 patients, endometriotic lesions were detectable by laparoscopy only. In the remaining 2 patients, no endometriosis was visible on MRI or by laparoscopy. MRI was able to visualize a total of 19 endometriotic lesions, with 14 (74%) confirmed by histopathologic examination following laparoscopy. Five of these 19 lesions (26%) visible on MRI were not seen by laparoscopy. Using laparoscopy and subsequent histopathologic examination, 27 endometriotic lesions were diagnosed, with 13 (48%) not seen on the preoperative MRI. Conclusion: MRI and laparoscopy are complementary diagnostic tools that will best document the full extent of endometriosis when combined. MRI can visualize additional lesions inaccessible to laparoscopy. Thus, MRI of the pelvis should used preoperatively for surgical treatment planning. (orig.)

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

International Nuclear Information System (INIS)

Tanigawa, Noboru; Kariya, Shuji; Komemushi, Atsushi; Satoi, Sohei; Kamiyama, Yasuo; Sawada, Satoshi; Kojima, Hiroyuki; Sougawa, Mitsuharu; Takai, Yuichirou

2004-01-01

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

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.

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)

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

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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.)

Normal Pancreas Anatomy

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... 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 ...

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

Long-term Outcomes for Living Pancreas Donors in the Modern Era.

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Kirchner, Varvara A; Finger, Erik B; Bellin, Melena D; Dunn, Ty B; Gruessner, Rainer W G; Hering, Bernhard J; Humar, Abhinav; Kukla, Aleksandra K; Matas, Arthur J; Pruett, Timothy L; Sutherland, David E R; Kandaswamy, Raja

2016-06-01

Living donor segmental pancreas transplants (LDSPTx) have been performed selectively to offer a preemptive transplant option for simultaneous pancreas-kidney recipients and to perform a single operation decreasing the cost of pancreas after kidney transplant. For solitary pancreas transplants, this option historically provided a better immunologic match. Although short-term donor outcomes have been documented, there are no long-term studies. We studied postdonation outcomes in 46 segmental pancreas living donors. Surgical complications, risk factors (RF) for development of diabetes mellitus (DM) and quality of life were studied. A risk stratification model (RSM) for DM was created using predonation and postdonation RFs. Recipient outcomes were analyzed. Between January 1, 1994 and May 1, 2013, 46 LDSPTx were performed. Intraoperatively, 5 (11%) donors received transfusion. Overall, 9 (20%) donors underwent splenectomy. Postoperative complications included: 6 (13%) peripancreatic fluid collections and 2 (4%) pancreatitis episodes. Postdonation, DM requiring oral hypoglycemics was diagnosed in 7 (15%) donors and insulin-dependent DM in 5 (11%) donors. RSM with three predonation RFs (oral glucose tolerance test, basal insulin, fasting plasma glucose) and 1 postdonation RF, greater than 15% increase in body mass index from preoperative (Δ body mass index >15), predicted 12 (100%) donors that developed postdonation DM. Quality of life was not significantly affected by donation. Mean graft survival was 9.5 (±4.4) years from donors without and 9.6 (±5.4) years from donors with postdonation DM. LDSPTx can be performed with good recipient outcomes. The donation is associated with donor morbidity including impaired glucose control. Donor morbidity can be minimized by using RSM and predonation counseling on life style modifications postdonation.

Preoperative diagnosis of breast diseases by dynamic MR mammography. Cut off point establishment for signal intensity ratio

International Nuclear Information System (INIS)

Tsuchiya, Juji; Nagata, Takayasu; Kawagoe, Hajime; Tachibana, Susumu; Kajima, Toshihiko; Hoshino, Mutsuo; Uno, Takashi; Shimokawa, Kuniyasu.

1997-01-01

We have revealed that a dynamic study of the breast using MR imaging technique can estimate objectively benign-malignant differentiative diagnosis. Subjects were 41 cases of breast lesion, including 13 cases of breast cancer, 21 cases of mastopathy, six cases of fibroadenoma and one case of intraductal papillomatosis and the results of them were investigated in comparison with histopathological diagnosis. As so the method, we drew up time-signal intensity ratio curve plotting signal intensity ratio at each 30 second of dynamic MR mammography after Gd-DTPA administration. We found a especially high significant difference between cancer and mastopathy, within 90 second after Gd-DTPA administration (p=0.0000). Still more, we established cut off point concerning with establishment of 95% confidence interval, that is, at 30 second after Gd-DTPA administration of point equivalent 1.53 at 60 second equivalent 2.00, at 90 second equivalent 2.47, and about this estimating maneuver using the cut off point we named Dynamic ratio method. We can estimate preoperatively not only benign-malignant differentiative diagnosis with breast tumor, but also neighboring infiltration and lymph node metastasis of breast cancer using this Dynamic ratio method. Over again, Dynamic ratio method provides fine information to preoperative decision of resecting region for breast conserving surgery. The efficiency of this method is sensitivity=92.3%, specificity=89.3% and positive predictive value=80.0%. (author)

Preoperative diagnosis of breast diseases by dynamic MR mammography. Cut off point establishment for signal intensity ratio

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Tsuchiya, Juji; Nagata, Takayasu; Kawagoe, Hajime; Tachibana, Susumu; Kajima, Toshihiko; Hoshino, Mutsuo [Ibi General Hospital, Gifu (Japan); Uno, Takashi; Shimokawa, Kuniyasu

1997-12-01

We have revealed that a dynamic study of the breast using MR imaging technique can estimate objectively benign-malignant differentiative diagnosis. Subjects were 41 cases of breast lesion, including 13 cases of breast cancer, 21 cases of mastopathy, six cases of fibroadenoma and one case of intraductal papillomatosis and the results of them were investigated in comparison with histopathological diagnosis. As so the method, we drew up time-signal intensity ratio curve plotting signal intensity ratio at each 30 second of dynamic MR mammography after Gd-DTPA administration. We found a especially high significant difference between cancer and mastopathy, within 90 second after Gd-DTPA administration (p=0.0000). Still more, we established cut off point concerning with establishment of 95% confidence interval, that is, at 30 second after Gd-DTPA administration of point equivalent 1.53 at 60 second equivalent 2.00, at 90 second equivalent 2.47, and about this estimating maneuver using the cut off point we named Dynamic ratio method. We can estimate preoperatively not only benign-malignant differentiative diagnosis with breast tumor, but also neighboring infiltration and lymph node metastasis of breast cancer using this Dynamic ratio method. Over again, Dynamic ratio method provides fine information to preoperative decision of resecting region for breast conserving surgery. The efficiency of this method is sensitivity=92.3%, specificity=89.3% and positive predictive value=80.0%. (author)

Isolated tubal torsion: Successful preoperative diagnosis of five cases using ultrasound and management with laparoscopy

Directory of Open Access Journals (Sweden)

Erdem Fadıloğlu

2017-09-01

Full Text Available Our aim was to evaluate the presentation and diagnostic evaluation of patients with isolated tubal torsion and to evaluate the surgical approach to these patients. We also aimed to define the ultrasonographic diagnostic criteria. Five patients with isolated tubal torsion who were admitted to our gynecology department between January 2014 and January 2017 were evaluated and included in this study. All cases were diagnosed through ultrasonographic imaging alone. The preoperative findings of the patients were similar to those described in the literature. No further imaging modality was used for diagnosis and all patients were managed with laparoscopy. The clinical findings and ultrasonographic findings were consistent with literature. It may be difficult to preoperatively diagnose isolated tubal torsion, which is a rare clinical entity. Evaluation of these patients by an experienced sonographer and knowledge of the ultrasonographic findings of isolated tubal torsion may have vital preventive measures.

Clinical significance of CT in the preoperative diagnosis of the staging of rectal cancer patients

International Nuclear Information System (INIS)

Itano, Satoshi; Fuchimoto, Sadanori; Hamada, Fumihiro; Kimura, Takanobu; Iwagaki, Hiromi; Maeda, Tetsuya; Orita, Kunzo

1987-01-01

The value of computed tomography (CT) in the preoperative clinical staging of rectal cancer was prospectively studied in 28 patients with macroscopically proven cancer. The CT studies were based on the previously established CT diagnostic criteria for wall invasion (S factor), lymph node metastases (N factor), and liver metastases (H factor). When macroscopic findings were used as the standard, the accuracy of CT was 61 % for S factor, 32 % for N factor, and 86 % for H factor. Using histological findings as the standard, the accuracy was 48 % for S factor and 16 % for N factor. Overall, CT had a high accuracy for H factor in all sites of cancer (75 % in the rectosigmoid, 86 % in the area above the peritoneal reflection, and 90 % in the area below the peritoneal reflection). For the other S and N factors, CT seemed to be of limited value in the preoperative diagnosis. (Namekawa, K.)

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.

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

Annular pancreas

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... 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 ...

In Patients with a Soft Pancreas, a Thick Parenchyma, a Small Duct, and Fatty Infiltration Are Significant Risks for Pancreatic Fistula After Pancreaticoduodenectomy.

Science.gov (United States)

Sugimoto, Motokazu; Takahashi, Shinichiro; Kojima, Motohiro; Kobayashi, Tatsushi; Gotohda, Naoto; Konishi, Masaru

2017-05-01

This study sought to characterize soft and hard pancreatic textures radiologically and histologically, and to identify specific risks in a soft pancreas associated with postoperative pancreatic fistula (POPF) formation after pancreaticoduodenectomy (PD). Consecutive 145 patients who underwent PD at a single institution between January 2010 and May 2013 were studied. Pancreatic consistency was intraoperatively judged as soft or hard. Pancreatic configuration was assessed using preoperative CT. Histologic components of the pancreatic stump were evaluated using a morphometric analysis. Clinicopathologic parameters were then analyzed for the risk of clinically relevant POPF. Compared with patients with a hard pancreas (n = 66), those with a soft pancreas (n = 79) had a smaller main pancreatic duct (MPD) diameter and a larger parenchymal thickness on CT, had a smaller fibrosis ratio and a larger lobular ratio histologically, and developed clinically relevant POPF more frequently (P pancreas, an MPD diameter pancreas, a thick parenchyma, a small MPD, and fatty infiltration were strongly associated with clinically relevant POPF after PD.

Resection of cancer of the body and tail of the pancreas

DEFF Research Database (Denmark)

Burcharth, Flemming; Trillingsgaard, Jesper; Olsen, Soren D

2003-01-01

tomography, endoscopic retrograde cholangiopancreatography and angiography. Eleven patients had distal or subtotal pancreatectomy and two patients total pancreatectomy. The surgical procedure included extensive dissection of lymph nodes and the connective tissue in the peripancreatic region. Main outcome......BACKGROUND/AIMS: To report our results of resection of cancer in the body and tail of the pancreas and review the literature. METHODOLOGY: Thirteen patients with a median age of 62 years with cancer of the body and/or tail of the pancreas. The diagnosis was made by ultrasonography, computed...

Added Value of Breast MRI for Preoperative Diagnosis of Ductal Carcinoma In Situ: Diagnostic Performance on 362 Patients.

Science.gov (United States)

Petrillo, Antonella; Fusco, Roberta; Petrillo, Mario; Triunfo, Flavia; Filice, Salvatore; Vallone, Paolo; Setola, Sergio Venanzio; Rubulotta, Mariarosaria; Di Bonito, Maurizio; Rinaldo, Massimo; D'Aiuto, Massimiliano; Brunetti, Arturo

2017-06-01

The purpose of this study was to evaluate the added value of breast magnetic resonance imaging (MRI) in preoperative diagnosis of ductal carcinoma in situ (DCIS). We reviewed our institution database of 3499 consecutive patients treated for breast cancer. A total of 362 patients with histologically proven DCIS were selected from the institutional database. Of these, 245 (67.7%) preoperatively underwent conventional imaging (CI) (mammography/ultrasonography) (CI group), and 117 (32.3%) underwent CI and dynamic MRI (CI + MRI group). The pathology of surgical specimens served as a reference standard. The Mann-Whitney U, χ 2 test, and Spearman correlation coefficient were performed. The CI + MRI group showed a sensitivity of 98.5% with an increase of 10.1% compared with the CI group to detect pure DCIS. Dynamic MRI identified 19.7% (n = 13) additional pure DCIS compared with CI. In the CI + MRI group, a single (1.5%) false negative was reported, whereas in the CI group, 11 (11.6%) false negatives were reported. Moreover, the CI + MRI group showed a sensitivity of 98.0% to detect DCIS + small invasive component. In this group, dynamic MRI identified 21.6% (n = 11) additional DCIS and a single (2.0%) false negative compared with the CI group, whereas in the CI group, 7 (4.7%) false negatives were reported. MRI and histopathologically measured lesion sizes, Breast Imaging Reporting and Data System MRI assessment categories, and enhancement signal intensity curve types showed a significant correlation. The MRI detection rate of DCIS increased significantly with increasing nuclear grade. Preoperative breast MRI showed a better accuracy then CI in preoperative diagnosis for both pure DCIS and DCIS + small invasive component with a precise assessment of lesion size. This can provide a more appropriate management of DCIS patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Mucinous cystic tumors of the pancreas - report of a radiological diagnostic and review of the literature

International Nuclear Information System (INIS)

Teixeira, Sonia Marcelino; Marchiori, Edson; Borges, Aurea Valeria Rosa Mohana; Dinoa, Vanessa de Albuquerque; Santos, Maria Cristina Soares dos

1997-01-01

Cystic lesions of the pancreas can be either inflammatory (pseudocyst) or neoplastic. Neoplastic cysts contain either serous or mucinous fluid. Mucinous cystic tumor are more common in the tail of the pancreas of young women with palpable upper abdominal mass. The treatment is total excision of the lesion, and has very good results. The authors report the case of a 41-year-old woman, who presented a large palpable upper abdominal mass and fever. Abdominal sonography and CT scan have shown a heterogeneous cyst in the pancreas body and tail. The histologic diagnosis was mucinous cystic tumor of the pancreas. The treatment was removal of the body and tail of the pancreas together with the cyst. One year after surgery, the patient is doing well. (author)

Solid pseudo papillary tumour of the pancreas: Report of one case;Tumeur pseudopapillaire et solide du pancreas: a propos d'un cas

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Michaud, L.; Baulieu, J.L. [CHU de Tours, Service de medecine nucleaire, 37 - Tours (France); Dujardin, F. [CHU de Tours, Service d' anatomopathologie, 37 - Tours (France); Cazals, X.; Besson, M. [CHU de Tours, Service de radiologie, hopital Trousseau, 37 - Tours (France); Isart, D.; Maillard, R. [Centre hospitalier de Blois, Service d' imagerie medicale, 41 - Blois (France); Marboeuf, Y. [Centre hospitalier de Blois, Service de chirurgie viscerale, 41 - Blois (France); Bruandet, P. [Centre hospitalier de Blois, Service d' anatomopathologie, 41 - Blois (France)

2010-02-15

Solid pseudo papillary tumour of the pancreas is a rare tumour that electively affects young women. Its clinical presentation is variable: it may be discovered incidentally or by the appearance of an epi-gastric mass or signs of biliary compression. Its prognosis is excellent after surgical resection. Imaging findings are essential, as they are sufficient to suggest the diagnosis without the need of a puncture-biopsy. {sup 18}F-F.D.G. PET-CT may indicate hyper-metabolic space-occupying lesion highly suggestive of aggressive tumour, while it tallies with a low malignancy tumour. These features may make PET-CT interpretation more erratic if these particular properties are ignored. We report the case of a 17-year-old woman who presented a solid and pseudo papillary tumour of the pancreas. The diagnosis was reached through various imaging tests (ultrasound, CT and PET-CT) in context of the medical history and was confirmed by the sample pathological analysis. (authors)

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.

Predictors of malignancy in intraductal papillary mucinous neoplasm of the pancreas: analysis of 310 pancreatic resection patients at multiple high-volume centers.

Science.gov (United States)

Shimizu, Yasuhiro; Yamaue, Hiroki; Maguchi, Hiroyuki; Yamao, Kenji; Hirono, Seiko; Osanai, Manabu; Hijioka, Susumu; Hosoda, Waki; Nakamura, Yasushi; Shinohara, Toshiya; Yanagisawa, Akio

2013-07-01

The present study was a retrospective investigation of predictors of malignancy in intraductal papillary mucinous neoplasm (IPMN) of the pancreas. The subjects were 310 patients who underwent pancreatic resection at 3 high-volume centers. Preoperative laboratory and imaging findings were analyzed in logistic regression analyses. Endoscopic ultrasonography measurements were essential for the size of mural nodules, and a central review was conducted for pathological diagnosis. Pathological diagnosis was benign IPMN in 150 cases and malignant in 160 (noninvasive carcinoma, n = 100; invasive, n = 60). In multivariate analysis, size of mural nodules, diameter of main pancreatic duct, and cyst size of branch pancreatic duct were independent predictors of malignancy, and areas under the receiver operating characteristic curve for these 3 factors were 0.798, 0.643, and 0.601, respectively. With 7 mm taken as the cutoff value for the size of mural nodules, the diagnosis of malignant IPMN had sensitivity of 74.3% and specificity of 72.7%. Carcinoma without nodules was present in 15 patients (15/160 [9.4%]). The size of mural nodules measured with endoscopic ultrasonography showed high predictive ability. However, about 10% of carcinoma patients did not have nodules, and the handling of the diagnosis in such cases is a problem for the future.

The Role of Fine Needle Aspiration in the Diagnosis of Parotid Gland Tumors: Correlation With Preoperative Computerized Tomography Tumor Size.

Science.gov (United States)

Ghantous, Yasmine; Naddaf, Raja; Barak, Michal; Abd-Elraziq, Murad; Abu Eln-Naaj, Imad

2016-03-01

The role of fine needle aspiration cytology (FNAC) in the diagnosis of parotid gland masses is still controversial, regarding its sensitivity and specificity that vary between 41% and 100% and between 86% and 100% respectively.The aim of this study was to identify the specificity and sensitivity of FNAC of parotid gland tumors in relation to the tumor size as characterized preoperatively by computer tomography. The medical files of 79 patients whom were referred to the MaxilloFacila Surgery Department, Rambam medical center, over a 10.5-year period (2000-2010) were analyzed retrospectively.The extensity of the operation was determined by the location of the tumor as presented in computed tomography (CT) radiography, and preoperative FNAC examination.The majority of the masses were located in the superficial lobe (88.52%), and only 11.48% of the patients were located in the deep lobe (8:1 ratio). FNAC results were nondiagnostic in 7 patients (8.86%), 62 patients were diagnosed as inflammatory and benign lesion in (78.48%), malignant tumors were diagnosed in 10 patients (12.65%).The sensitivity in our study was 90%, the specificity was 98%, positive predictive value was 90%, negative predictive value was 98%, and diagnostic accuracy was 88%. The positive predictive value was 90%, the negative predictive value was 98%.Analyzing the effect of the preoperative CT size upon the accuracy of the FNAC diagnosis, we found that lesion with preoperative CT size greater than 24 mm has a more accurate FNAC result (P = 0.034).

CT-arteriography of pancreas

International Nuclear Information System (INIS)

Yoshikawa, Jun; Matsui, Osamu; Kitagawa, Kiyohide; Kamimura, Ryoichi; Kadoya, Masumi; Suzuki, Masayuki; Takashima, Tutomu

1985-01-01

To evaluate diagnostic effectiveness of CT-arteriography (CTA) in pancreatic disease, the pictures of pancreatic CTA were analysed in 50 cases without pancreatic disease. In the pancreatic body, irregular spotty stain was seen in 15 out of 50 cases(30%). Especially, in patients who had dorsal pancreatic artery arising from superior mesenteric artery, this stain was seen in 9 out of 13 cases(69%) and its mechanism was considered to be double blood supply both from celiac artery and superior mesenteric artery. As a consequence, we think that CTA of pancreas is unusefull in diagnosis of pancreatic insulinomas or carcinomas. (author)

CT-arteriography of pancreas

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Yoshikawa, Jun; Matsui, Osamu; Kitagawa, Kiyohide; Kamimura, Ryoichi; Kadoya, Masumi; Suzuki, Masayuki; Takashima, Tutomu

1985-01-01

To evaluate diagnostic effectiveness of CT-arteriography (CTA) in pancreatic disease, the pictures of pancreatic CTA were analysed in 50 cases without pancreatic disease. In the pancreatic body, irregular spotty stain was seen in 15 out of 50 cases(30%). Especially, in patients who had dorsal pancreatic artery arising from superior mesenteric artery, this stain was seen in 9 out of 13 cases(69%) and its mechanism was considered to be double blood supply both from celiac artery and superior mesenteric artery. As a consequence, we think that CTA of pancreas is unusefull in diagnosis of pancreatic insulinomas or carcinomas. (author).

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.

Peritoneal implants without ascites. Preoperative CT diagnosis in colon carcinoma patients

International Nuclear Information System (INIS)

Saida, Yukihisa; Itai, Yuji; Tsunoda, Hiroko; Matsueda, Kiyoshi.

1994-01-01

We evaluated the preoperative CT findings in 10 patients with colon carcinoma in whom peritoneal metastases had been surgically confirmed. Seven patients lacked ascites. No CT findings suggestive of peritoneal metastasis were observed in two patients without ascites even by retrospective evaluation. A large mass was observed in the cul-de-sac in another. In the remaining four patients, small peritoneal metastases ranging from 8 to 11 mm in diameter were observed at the omentum in two, along the falciform ligament in one, and at both the omentum and the iliac fossa in one; three of these patients had received no prospective diagnosis of peritoneal metastasis prior to the surgery. In patients with advanced colon carcinoma with suspected serosal invasion, the entire peritoneal cavity should be carefully examined and interpreted using CT in order to detect small peritoneal implants even when ascites is absent. (author)

Accuracy of routine cytology and immunocytochemistry in preoperative diagnosis of oral amelanotic melanomas in dogs.

Science.gov (United States)

Przeździecki, Rafał; Czopowicz, Michał; Sapierzyński, Rafał

2015-12-01

Amelanotic melanomas are one of the most common oral malignancies. The cytologic and histopathologic differentiation between amelanotic melanoma, sarcoma, and poorly differentiated carcinoma is often difficult or even impossible. The aim of this study was to assess the reliability of routine cytology and immunocytochemistry in preoperative diagnosis of canine oral amelanotic melanoma. Cytologic preparations from undifferentiated canine oral tumors were stained with Giemsa and by immunocytochemistry (ICC) using anti-cytokeratin, anti-vimentin, and anti-Melan A antibodies. The final cytologic diagnosis (including ICC) was compared to the final diagnosis based on histopathology and immunohistochemistry (IHC) results, and sensitivity and specificity of cytologic examination were determined. Final cytologic diagnoses of 38 cases agreed well with the histopathologic/immunohistochemical diagnoses, thus both specificity and sensitivity of combined routine cytology and ICC were 100% (95% confidence interval 90.8-100%). Of 32 oral tumors, diagnosis of amelanotic melanoma, sarcoma, and carcinoma was made using routine cytology and ICC. In 4 of 6 aspirates taken from lymph nodes, a preliminary diagnosis of metastatic amelanotic melanoma corresponded with the final diagnosis. Both sensitivity and specificity of routine cytology in diagnosis of amelanotic melanomas were considered moderate (66.7% and 85.7%, respectively). In conclusion, routine cytology is a reliable diagnostic method for canine oral amelanotic melanoma and metastatic amelanotic melanoma, and ICC, using anti-cytokeratin, anti-vimentin, and anti-Melan A antibodies, is an excellent supporting method for presurgical diagnosis of poorly differentiated oral malignancies in dogs. © 2015 American Society for Veterinary Clinical Pathology.

Preoperative local MRI-staging of patients with a suspected pancreatic mass.

Science.gov (United States)

Fischer, U; Vosshenrich, R; Horstmann, O; Becker, H; Salamat, B; Baum, F; Grabbe, E

2002-02-01

The aim of this study was to define the value of MRI of the pancreas for preoperative local staging of patients with a suspected pancreatic mass. Ninety-four patients (41 women, 53 men; age range 32-87 years) with a suspected pancreatic tumor underwent preoperative staging with MRI on a 1.5-T system. The MRI protocol included breath-hold MR cholangiopancreatography in turbo spin-echo technique, biphasic contrast-enhanced 3D MR angiography, and MRI of the upper abdomen with breath-hold T2-weighted half-Fourier acquired single-shot turbo spin-echo and T1-weighted fast-low-angle-shot (pre- and postcontrast) sequences. Data were collected prospectively and analyzed by two radiologists in agreement modality. Evaluation criteria were vascular involvement, resectability, and a characterization benign vs malignant. Results were compared to histopathology in 78 patients. Sixteen patients were followed-up. In 74 of 94 patients a solid tumor or an inflammation of the pancreas ( n=62) or the papilla ( n=12) was detected. In this group, MRI had a sensitivity of 98%, a specificity of 92%, and an accuracy of 96% in the characterization of malignant tumors. Regarding only the solid tumors, the positive predictive value of MRI was 87% with respect to resectability. Other pathologic findings included adenoma or inflammation of the duodenum ( n=5), carcinoma or benign stenosis of the choledochus duct ( n=7) and carcinoma of the gall bladder ( n=2). In 6 patients MRI did not depict any pathologic findings, and follow-up confirmed this interpretation. Magnetic resonance imaging allows a local preoperative staging in patients with suspected pancreatic tumor. Limitations, however, concern to the diagnostics of peritoneal and/or liver metastases.

Non-small cell lung cancer: Spectral computed tomography quantitative parameters for preoperative diagnosis of metastatic lymph nodes

Energy Technology Data Exchange (ETDEWEB)

Yang, Fengfeng [Department of Radiology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin 150001 (China); Dong, Jie [Department of Geriatrics, The First Affiliated Hospital, Harbin Medical University, Harbin 150001 (China); Wang, Xiuting; Fu, Xiaojiao [Department of Radiology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin 150001 (China); Zhang, Tong, E-mail: zt415@sina.com [Department of Radiology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin 150001 (China)

2017-04-15

Objective: To investigate the application value of spectral computed tomography (CT)quantitative parameters for preoperative diagnosis of metastatic lymph nodes in patients with non-small cell lung cancer (NSLC). Methods: 84 patients with suspected lung cancer who underwent chest dual-phase enhanced scan with gemstone spectral CT imaging (GSI) mode were selected. GSI quantitative parameters including normalized iodine concentrations (NIC), water concentration, slope of the spectral Hounsfield unit curve (λHU) were measured. The two-sample t test was used to statistically compare these quantitative parameters. Receiver operating characteristic (ROC) curves were drawn to establish the optimal threshold values. Results: A total of 144 lymph nodes were included, with 48 metastatic lymph nodes and 96 non-metastatic lymph nodes. The slope of the spectral Hounsfeld unit curve (λHU) measured during both arterial and venous phases were signifcantly higher in metastatic than in benign lymph nodes (P < 0.05). The area under the ROC curve (AUC = 0.951) of λHU of the arterial phase (AP) was the largest. When the optimal threshold values of λHU was 2.75, the sensitivity, specificity, and overall accuracy in the diagnosis of metastatic lymph nodes were 88.2%, 88.4%, 87.0%, respectively. Conclusion: Conventional CT diagnostic criteria established in accordance with size (lymph node maximal short axis diameter ≥10 mm) as the basis for judging metastatic lymph node. In quantitative assessment using spectral CT imaging, quantitative parameters showed higher accuracy than qualitative assessment of conventional CT based on the size for preoperative diagnosis of metastatic lymph nodes.

Pancreas cancer

International Nuclear Information System (INIS)

Yamada, Shigeru; Kato, Hirotoshi; Hara, Ryusuke

2006-01-01

Adenocarcinoma of the pancreas continues to be a significant source of cancer mortality in Japan, resulting in approximately 19,000 deaths a year. It is the fifth leading cause of cancer-related deaths in Japan, with a less than 5% 5-year expected survival rate. About 70-75% of patients with pancreas cancer present with locally advanced disease or distant metastases and have a median survival time of only 6 months. For unresectable pancreas cancer, the median survival time with external beam radiation (EBRT) was better than with surgical bypass or stents alone. The median survival of EBRT alone was 4 to 7 months. The median survival with combined EBRT and chemotherapy for locally unresectable tumor are 8 to 10 months and better than with the EBRT alone. Local failure of these combined therapies was still 26 to 48%. On the other hand, surgery with curative intent is undertaken in 15-20% of patients. Even after resection, the predicted 5-year survival rates are still less than 20%. Local recurrences in the pancreatic bed are seen in 50% of the patients undergoing presumed curative resection. We examined the effect of carbon ion therapy in terms of reducing the rate of local recurrence in patients with locally advanced adenocarcinoma of the pancreas or undergoing resection for adenocarcinoma of the pancreas. (author)

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.

Academic Pancreas Centers of Excellence: Guidance from a multidisciplinary chronic pancreatitis working group at PancreasFest

Science.gov (United States)

Sheth, Sunil G.; Conwell, Darwin L.; Whitcomb, David C.; Alsante, Matthew; Anderson, Michelle A.; Barkin, Jamie; Brand, Randall; Cote, Gregory A.; Freedman, Steven D.; Gelrud, Andres; Gorelick, Fred; Lee, Linda S.; Morgan, Katherine; Pandol, Stephen; Singh, Vikesh K.; Yadav, Dhiraj; Mel Wilcox, C.; Hart, Phil A.

2017-01-01

Chronic pancreatitis (CP) is a progressive inflammatory disease, which leads to loss of pancreatic function and other disease-related morbidities. A group of academic physicians and scientists developed comprehensive guidance statements regarding the management of CP that include its epidemiology, diagnosis, medical treatment, surgical treatment, and screening. The statements were developed through literature review, deliberation, and consensus opinion. These statements were ultimately used to develop a conceptual framework for the multidisciplinary management of chronic pancreatitis referred to as an academic pancreas center of excellence (APCOE). PMID:28268158

Pancreas divisum as a possible cause of misinterpretation in ERCP, computed tomography, ultrasound and barium meal

International Nuclear Information System (INIS)

Brambs, H.J.; Schuetz, B.; Wimmer, B.; Hoppe-Seyler, P.; Freiburg Univ.

1986-01-01

In 488 patients endoscopic retorgrade pancreatography (ERP) revealed a pancreas divisum in 21 (4.3%): in 17/21 patients we found a complete, in 4/21 an incomplete separation of the pancreatic ducts. The pancreas divisum is caused by a malfusion of the ductal system. On examination by ultrasound, computed tomography or hypotonic duodenography this variant can suggest an inflammation or tumour of the head of the pancreas. A definite diagnosis is possible by ERP only. Since the small ventral duct can be confused with an alteration caused by inflammation or by a tumour, to much of contrast medium can be injected. Pancreas divisum is often associated with a chronic pancreatitis which can be demonstrated via ERP of the dorsal duct through the accessory papilla. (orig.) [de

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

Serial computed tomography and its uses in the diagnosis of pathological changes in the liver, pancreas and kidneys

International Nuclear Information System (INIS)

Schmiedel, R.

1983-01-01

The investigations described were carried out in such a way as to fulfil the defined requirements of serial computed tomography like short periods of measurement, high scanning frequency and intravasal bolus injection of a contrast medium that would readily be excreted by the renal route. In this connection, the following questions were of particular interest: 1. Is computed serial tomography able to provide better clues to tissue identification and the distinction between normal and pathological structures in the liver, pancreas and kidneys? 2. Would it be possible to obtain information as to the degree of vascularisation in space-occupying pathological processes in the liver, pancreas and kidneys? 3. Is serial computed tomography a useful tool to diagnose specific pathological changes in the liver, pancreas and kidneys? 4. Would this investigation permit predictions to be made about the functional performance of the liver, pancreas and kidneys? (orig./MG) [de

An Unusual Presentation of Annular Pancreas: A Case Report

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Saleheh Ala

2015-01-01

Full Text Available Abstract Annular pancreas (AP is a rare congenital malformation resulting from failure of pancreas ventral anlage rotation with the duodenum. This leads to a ring of pancreatic tissue that envelops the duodenum. Clinical manifestations of AP most commonly develop in infancy or early childhood but can present at any age. The diagnosis of AP, usually suggested by an upper GI series or abdominal CT scan, but surgery is considered the gold standard diagnostic method. Surgical bypass of the annulus in all patients with symptomatic AP is recommended. We report a one year old girl who presented with intermittent, non projectile, non bilious vomiting that occurred 1h to 2h after feeding since neonatal period. Upper GI contrast study demonstrates, a dilated duodenal bulb associated with narrowing of post bulbar area. The patient underwent surgical correction of the obstruction. A bypass of the ectopic pancreas tissue was performed by duodenoduodenostomy. Considering the rarity of this congenital abnormality, presenting with chronic partial duodenal obstruction, and its successful correction by surgical means have prompted us to report the case.

Diagnostic imagings of malignant lymphoma of the pancreas with obstructive jaundice

International Nuclear Information System (INIS)

Shirahase, Isao; Kobayashi, Nobuaki; Tanimura, Hiroshi; Yamaoka, Yoshio; Ozawa, Kazue; Hayashi, Nobushige; Itoh, Kyo; Nakajima, Yasuaki

1987-01-01

We performed pancreatoduodenectomy in a 41-year-old man with pancreatic malignant lymphoma, who began to have obstructive jaundice and in whom imaging showed a tumor of the head of the pancreas with extrapancreatic growth. The tumor was 8 x 8.5 x 4 cm in size. The histopathological findings of the tumor indicated a malignant lymphoma, non-Hodgkin, diffuse large cell type. The patient was discharged after receiving nine courses of postoperative chemotherapy with VEPA. It is very important in determing the surgical indication to preoperatively differentiate malignant lymphoma from pancreatic cancer, since malignant lymphoma originating from the gastrointestinal organs can, in some cases, be almost completely repaired if the tumor is removed in the early stage. Thus, it is possible to achieve effective multidisciplinary treatment for malignant lymphoma by performing closer preoperative examinations and taking into consideration the possibility of the existence of malignant lymphoma. This paper discusses the details of the imaging necessary to differentiate pancreatic malignant lymphoma. (author)

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 ...

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 ...

Solid pseudo papillary tumour of the pancreas: Report of one case

International Nuclear Information System (INIS)

Michaud, L.; Baulieu, J.L.; Dujardin, F.; Cazals, X.; Besson, M.; Isart, D.; Maillard, R.; Marboeuf, Y.; Bruandet, P.

2010-01-01

Solid pseudo papillary tumour of the pancreas is a rare tumour that electively affects young women. Its clinical presentation is variable: it may be discovered incidentally or by the appearance of an epi-gastric mass or signs of biliary compression. Its prognosis is excellent after surgical resection. Imaging findings are essential, as they are sufficient to suggest the diagnosis without the need of a puncture-biopsy. 18 F-F.D.G. PET-CT may indicate hyper-metabolic space-occupying lesion highly suggestive of aggressive tumour, while it tallies with a low malignancy tumour. These features may make PET-CT interpretation more erratic if these particular properties are ignored. We report the case of a 17-year-old woman who presented a solid and pseudo papillary tumour of the pancreas. The diagnosis was reached through various imaging tests (ultrasound, CT and PET-CT) in context of the medical history and was confirmed by the sample pathological analysis. (authors)

Preoperative local MRI-staging of patients with a suspected pancreatic mass

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Fischer, U.; Vosshenrich, R.; Salamat, B.; Baum, F.; Grabbe, E. [Department of Radiology, Georg August University, Goettingen (Germany); Horstmann, O.; Becker, H. [Department of Surgery, Georg August University, Goettingen (Germany)

2002-02-01

The aim of this study was to define the value of MRI of the pancreas for preoperative local staging of patients with a suspected pancreatic mass. Ninety-four patients (41 women, 53 men; age range 32-87 years) with a suspected pancreatic tumor underwent preoperative staging with MRI on a 1.5-T system. The MRI protocol included breath-hold MR cholangiopancreatography in turbo spin-echo technique, biphasic contrast-enhanced 3D MR angiography, and MRI of the upper abdomen with breath-hold T2-weighted half-Fourier acquired single-shot turbo spin-echo and T1-weighted fast-low-angle-shot (pre- and postcontrast) sequences. Data were collected prospectively and analyzed by two radiologists in agreement modality. Evaluation criteria were vascular involvement, resectability, and a characterization benign vs malignant. Results were compared to histopathology in 78 patients. Sixteen patients were followed-up. In 74 of 94 patients a solid tumor or an inflammation of the pancreas (n=62) or the papilla (n=12) was detected. In this group, MRI had a sensitivity of 98%, a specificity of 92%, and an accuracy of 96% in the characterization of malignant tumors. Regarding only the solid tumors, the positive predictive value of MRI was 87% with respect to resectability. Other pathologic findings included adenoma or inflammation of the duodenum (n=5), carcinoma or benign stenosis of the choledochus duct (n=7) and carcinoma of the gall bladder (n=2). In 6 patients MRI did not depict any pathologic findings, and follow-up confirmed this interpretation. Magnetic resonance imaging allows a local preoperative staging in patients with suspected pancreatic tumor. Limitations, however, concern to the diagnostics of peritoneal and/or liver metastases. (orig.)

Preoperative local MRI-staging of patients with a suspected pancreatic mass

International Nuclear Information System (INIS)

Fischer, U.; Vosshenrich, R.; Salamat, B.; Baum, F.; Grabbe, E.; Horstmann, O.; Becker, H.

2002-01-01

The aim of this study was to define the value of MRI of the pancreas for preoperative local staging of patients with a suspected pancreatic mass. Ninety-four patients (41 women, 53 men; age range 32-87 years) with a suspected pancreatic tumor underwent preoperative staging with MRI on a 1.5-T system. The MRI protocol included breath-hold MR cholangiopancreatography in turbo spin-echo technique, biphasic contrast-enhanced 3D MR angiography, and MRI of the upper abdomen with breath-hold T2-weighted half-Fourier acquired single-shot turbo spin-echo and T1-weighted fast-low-angle-shot (pre- and postcontrast) sequences. Data were collected prospectively and analyzed by two radiologists in agreement modality. Evaluation criteria were vascular involvement, resectability, and a characterization benign vs malignant. Results were compared to histopathology in 78 patients. Sixteen patients were followed-up. In 74 of 94 patients a solid tumor or an inflammation of the pancreas (n=62) or the papilla (n=12) was detected. In this group, MRI had a sensitivity of 98%, a specificity of 92%, and an accuracy of 96% in the characterization of malignant tumors. Regarding only the solid tumors, the positive predictive value of MRI was 87% with respect to resectability. Other pathologic findings included adenoma or inflammation of the duodenum (n=5), carcinoma or benign stenosis of the choledochus duct (n=7) and carcinoma of the gall bladder (n=2). In 6 patients MRI did not depict any pathologic findings, and follow-up confirmed this interpretation. Magnetic resonance imaging allows a local preoperative staging in patients with suspected pancreatic tumor. Limitations, however, concern to the diagnostics of peritoneal and/or liver metastases. (orig.)

Nocardiosis in a Kidney-Pancreas Transplant

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I. Fontana

2010-01-01

Full Text Available 34-year-old man with chronic renal and pancreas failure in complicated diabetic disease received a kidney-pancreas transplantation. On the 32nd postoperative day, an acute kidney rejection occurred and resolved with OKT3 therapy. The patient also presented refractory urinary infection by E. Fecalis and M. Morganii, and a focal bronchopneumonia in the right-basal lobe resolved with elective chemotherapy. During the 50th post-operative day, an intense soft tissue inflammation localized in the first left metatarsal-phalangeal articulation occurred (Figure 1 followed by an abscess with a cutaneous fistula and extension to the almost totality of foot area. The radiological exam revealed a small osteo-lacunar image localized in the proximal phalanx head of the first finger foot. From the cultural examination of the purulent material, N. Asteroides was identified. An amoxicillin-based treatment was started and continued for three months, with the complete resolution of infection This case is reported for its rarity in our casuistry, and for its difficult differential diagnosis with other potentially serious infections.

Echinococcal cyst of the pancreas with Cystopancreatic duct fistula ...

African Journals Online (AJOL)

The primary pancreatic hydatid (echinococcal) cyst is extremely rare with a reported incidence of <1%. Owing to its rareness and a considerable overlap of imaging features, a preoperative diagnosis is usually difficult. The dilemma in confirming this benign diagnosis has often questioned the extent of radical pancreatic ...

The importance of preoperative tissue sampling for mobile spine chordomas: literature review and report of two cases.

Science.gov (United States)

Zuccato, Jeffrey A; Witiw, Christopher D; Keith, Julia; Dyer, Erin; Saghal, Arjun; da Costa, Leodante

2018-01-01

Pre-operative biopsy and diagnosis of chordomas of the mobile spine is indicated as en bloc resections improve outcomes. This review of the management of mobile spine chordomas includes two cases of unexpected mobile spine chordomas where a preoperative tissue diagnosis was decided against and may have altered surgical decision-making. Two lumbar spine chordomas thought to be metastatic and primary bony lesions preoperatively were not biopsied before surgery and eventual pathology revealed chordoma. Preoperative diagnoses were questioned during surgery after an intraoperative tissue diagnosis of chordoma in one case and unclear pathology with non-characteristic tumor morphology in the other. The surgical plan was altered in these cases to maximize resection as en bloc resection reduces the risk of local recurrence in chordoma. Mobile spine chordomas are rare and en bloc resection is recommended, contrary to the usual approach to more common spine tumors. Since en bloc resection of spine chordomas improves disease free survival, it has been recommended that tissue diagnosis be obtained preoperatively when chordoma is considered in the differential diagnosis, in order to guide surgical planning. We present two cases where a preoperative biopsy was considered but not obtained after neuroradiology consultation and imaging review, which may have been managed differently if the diagnosis of spine chordomas were known pre-operatively.

Esophagogastric pathology in morbid obese patient: preoperative diagnosis and influence in the selection of surgical technique

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Sergio Estévez-Fernández

2015-07-01

Full Text Available Introduction: Given the difficulty in accessing to the excluded stomach after gastric bypass and the increase in gastroesophageal reflux after sleeve gastrectomy, it is justified to perform a preoperative fibrogastroscopy. The influence of the fibrogastroscopy (FGS findings in the therapeutic approach is analyzed. Patients and methods: A retrospective study of preoperative FGS findings is performed, from 04/06 to 12/12. The influence of the FGS results on the surgical technique selection, in the endoscopic or medical treatment and its relation to gastric fistula is analyzed by means of multivariate regression (confounding factors: Age, body mass index, arterial hypertension, diabetes mellitus, antiplatelet therapy, surgical technique (bariatric surgery, sleeve gastrectomy. Results: Three hundred thirty one patients are included: 32.6% biopsy of gastric lesion; 27% gastritis; 18.1% hiatal hernia; 3% metaplasia; 0.6% Barrett esophagus; 2.1% esophagitis; 0.3% dysplasia; 0.3 Schatzky's ring; 1.5% incompetent cardia; 2.4% duodenitis; 0.3% gastric erosions; 0.6% gastric xanthoma; 1.8%, gastric polyp; 1.6% duodenal ulcer; 0.6% papulo-erosive gastritis; 0.6% esophageal papilloma; 0.3% submucosal tumor. Helicobacter pylori+ 30.2% (triple therapy eradication in all patients. The FGS findings led to a variation in the surgical technique or to the completion of endoscopic treatment in 22.2% of cases. The gastric lesions did not influence the development of gastric fistula. Independent prognostic factors of fistula: Sleeve gastrectomy (7.9% vs. 2.7%; p = 0.02; OR: 1.38 IC95: 1.01-1.87 and the body mass index > 50 kg/m² (6.7% vs. 2.2%; p = 0.04; OR: 3.7 IC95: 1.12-12.4. Conclusions: The diagnosis of gastroesophageal disease through preoperative FGS motivated variations in the therapeutic approach in 52% of patients, so we consider essential to include the preoperative FGS in bariatric surgery.

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.

Imaging Findings of Localized Lymphoid Hyperplasia of the Pancreas: a Case Report

International Nuclear Information System (INIS)

Kim, Jin Woong; Heo, Suk Hee; Jeong, Yong Yeon; Kang, Heoung Keun; Shin, Sang Soo; Choi, Yoo Duk

2011-01-01

We report here on a case of localized lymphoid hyperplasia of the pancreas in a 70-year-old man which manifested as double lesions (uncinate process and tail) in the organ. The lesions were incidentally detected as hypoechoic lesions on ultrasonography and they appeared as delayed enhancing lesions on the contrast-enhanced dynamic CT and MRI. Total pancreatectomy was performed, because malignant tumor could not be excluded according to the preoperative imaging studies and the endoscopic ultrasound-guided biopsy failed. Pathology revealed localized lymphoid hyperplasia. The patient had an uneventful postoperative course. He has been alive for 18 months after surgery.

Imaging Findings of Localized Lymphoid Hyperplasia of the Pancreas: a Case Report

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Kim, Jin Woong; Heo, Suk Hee; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Hwasun Hospital and Medical School, Hwasun (Korea, Republic of); Shin, Sang Soo; Choi, Yoo Duk [Chonnam National University Hospital and Medical School, Gwangju (KR)

2011-08-15

We report here on a case of localized lymphoid hyperplasia of the pancreas in a 70-year-old man which manifested as double lesions (uncinate process and tail) in the organ. The lesions were incidentally detected as hypoechoic lesions on ultrasonography and they appeared as delayed enhancing lesions on the contrast-enhanced dynamic CT and MRI. Total pancreatectomy was performed, because malignant tumor could not be excluded according to the preoperative imaging studies and the endoscopic ultrasound-guided biopsy failed. Pathology revealed localized lymphoid hyperplasia. The patient had an uneventful postoperative course. He has been alive for 18 months after surgery.

Pancreas divisum: Analysis and therapeutic alternatives with a case report

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Jokić Radoica

2013-01-01

Full Text Available Introduction. Pancreas divisum is a relatively common pancreatic duct anatomic variant, firstly described in the 17th century. Case report. We reported a 2-year-old child admitted to the Pediatric Clinic with breathing difficulties and abdominal pains. Examination and X-ray image, showed a vast right hydrothorax containing rusty coloured solution with a high degree of amylase. Ultrasound and computed tomography examination revealed pancreatic polycyclic pseudocysts; following magnetic resonance cholangiopancreatography (MRCP, the diagnosis of pancreas divisum was confirmed. The general condition of the patient worsened, requiring an urgent operation. External drainage of the perforated pancreatic pseudocyst was performed. Following external fistula maturation, a change from external to internal drainage was performed using Roux-en-Y fistulojejunostomy. A 3-year postoperative period was uneventful. Conclusion. Pancreas divisum cases are unique requiring clinical experience, rational approach, and complex multimodal management. MRCP is a valuable diagnostic method. Amongst therapeutic options, outer and internal drainage can be seen as reliable methods. Further investigations are absolutely required to determine practical and appropriate conclusions.

The roles of the liver and pancreas in renal nutcracker syndrome

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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

Pancreatic arterial calcium stimulation in the diagnosis and localisation of persistent hyperinsulinemic hypoglycaemia of infancy

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Chigot, V.; Brunelle, F. [Department of Radiology, Hopital des Enfants Malades, Paris (France); Lonlay, P. de; Nassogne, M.-C.; Delagne, V.; Saudubray, J.-M. [Dept. of Paediatrics, Hopital des Enfants Malades, Paris (France); Laborde, K. [Dept. of Biology, Hopital des Enfants Malades, Paris (France); Fournet, J.-C. [Dept. of Pathology, Hopital des Enfants Malades, Paris (France); Nihoul-Fekete, C. [Department of Surgery, Hopital des Enfants Malades, Paris (France)

2001-09-01

Persistent hyperinsulinemic hypoglycaemia of infancy (PHHI) is often resistant to medical therapy. Surgery is therefore necessary. It is due to focal adenomatous islet-cell hyperplasia treatable by partial pancreatectomy, or diffuse beta-cell hyperfunction, which requires near-total pancreatectomy. Pancreatic venous sampling (PVS) is the reference technique for the preoperative diagnosis and localization of focal forms of PHHI in the pancreas. However, hypoglycaemia is necessary to analyse the results and PVS is technically challenging. Pancreatic arterial calcium stimulation (PACS) is technically easier and does not require hypoglycaemia. To study the accuracy in the diagnosis and localization of PHHI. Materials and methods: PACS was performed in 12 patients and correlated with histology. The accuracy of PACS is poor in diffuse lesions since only two of six cases were correctly identified by this test. Five of six focal lesions were correctly recognized and located. PACS is less accurate than PVS in PHHI. Currently, it should be performed only when PVS fails. (orig.)

Pancreatic arterial calcium stimulation in the diagnosis and localisation of persistent hyperinsulinemic hypoglycaemia of infancy

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Chigot, V.; Brunelle, F.; Lonlay, P. de; Nassogne, M.-C.; Delagne, V.; Saudubray, J.-M.; Laborde, K.; Fournet, J.-C.; Nihoul-Fekete, C.

2001-01-01

Persistent hyperinsulinemic hypoglycaemia of infancy (PHHI) is often resistant to medical therapy. Surgery is therefore necessary. It is due to focal adenomatous islet-cell hyperplasia treatable by partial pancreatectomy, or diffuse beta-cell hyperfunction, which requires near-total pancreatectomy. Pancreatic venous sampling (PVS) is the reference technique for the preoperative diagnosis and localization of focal forms of PHHI in the pancreas. However, hypoglycaemia is necessary to analyse the results and PVS is technically challenging. Pancreatic arterial calcium stimulation (PACS) is technically easier and does not require hypoglycaemia. To study the accuracy in the diagnosis and localization of PHHI. Materials and methods: PACS was performed in 12 patients and correlated with histology. The accuracy of PACS is poor in diffuse lesions since only two of six cases were correctly identified by this test. Five of six focal lesions were correctly recognized and located. PACS is less accurate than PVS in PHHI. Currently, it should be performed only when PVS fails. (orig.)

Abdominal Cocoon Syndrome (Idiopathic Sclerosing Encapsulating Peritonitis: How Easy Is Its Diagnosis Preoperatively? A Case Report

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Julius A. A. Awe

2013-01-01

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

Avoiding restorative proctocolectomy for colorectal cancer in patients with ulcerative colitis based on preoperative diagnosis involving p53 immunostaining: report of a case.

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Sada, Haruki; Shimomura, Manabu; Hinoi, Takao; Egi, Hiroyuki; Kawaguchi, Koji; Yano, Takuya; Niitsu, Hiroaki; Saitou, Yasufumi; Sawada, Hiroyuki; Miguchi, Masashi; Adachi, Tomohiro; Ohdan, Hideki

2015-03-26

The standard operation for colitic cancer in ulcerative colitis (UC) is restorative proctocolectomy; however, sporadic colorectal cancer (CRC) can coincidentally arise in patients with UC and the optimal procedure remains controversial. Therefore, it is crucial to preoperatively determine whether the CRC in UC is a sporadic or colitic cancer. We report a case of avoiding proctocolectomy for sporadic CRC in a patient with UC based on preoperative diagnosis involving p53 immunostaining. A 73-year-old man with CRC in UC had undergone sigmoid colectomy with lymphadenectomy because of the submucosal deep invasion pathologically after endoscopic mucosal resection. The cancer was diagnosed sporadic cancer preoperatively not only based on the endoscopic, clinical, and histological patterns but also that the colon epithelium was unlikely to develop dysplasia as the circumference and unaffected UC mucosa did not detect p53 protein overexpression. Recent reports have shown that the immunohistochemical detection of p53 protein overexpression can be useful for a differential diagnosis and as a predictor of dysplasia and colitic cancer. The analysis of p53 mutation status based on immunostaining of p53 protein expression in the unaffected UC mucosa can be useful for the decision regarding a surgical procedure for CRC in patients with UC.

The “Endothelialized Muscularis Mucosae”: A Case Report Describing a Large Cavernous Hemangioma at the Terminal Ileum and a New Histologic Clue for Preoperative Diagnosis from Endoscopic Biopsy

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Purdy-Payne, Erin K.; Miner, Jean F.; Foles, Brandon; Tran, Tien-Anh N.

2015-01-01

Cavernous hemangiomas of the gastrointestinal tract are quite rare and, until now, have been difficult to diagnose preoperatively due their nonspecific presentations and imaging features, as well as a lack of histologic description pertaining to small superficial biopsies such as those obtained endoscopically. We report a unique case of a 4 cm transmural cavernous hemangioma in the terminal ileum with literature review and describe a new histologic finding—the “endothelialized muscularis mucosae,” which was discovered upon review of the endoscopic biopsy and could potentially facilitate preoperative diagnosis of these lesions from endoscopic biopsies in the future. These lesions have classically required surgical resection in order to make a definitive diagnosis and rule out malignancy, with which they share many historical and radiographic features. Due to their potential to cause bowel obstruction, intussusception, perforation, and hemorrhage, these lesions may ultimately require surgical resection to relieve symptoms or prevent or treat complications—however, surgical planning and patient counseling could be greatly improved by a preoperative diagnosis. Therefore, gastroenterologists, pathologists, and surgeons should be aware of the “endothelialized muscularis mucosae” which can be very helpful in diagnosing GI cavernous hemangiomas from endoscopic biopsies. PMID:26442160

The “Endothelialized Muscularis Mucosae”: A Case Report Describing a Large Cavernous Hemangioma at the Terminal Ileum and a New Histologic Clue for Preoperative Diagnosis from Endoscopic Biopsy

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Erin K. Purdy-Payne

2015-01-01

Full Text Available Cavernous hemangiomas of the gastrointestinal tract are quite rare and, until now, have been difficult to diagnose preoperatively due their nonspecific presentations and imaging features, as well as a lack of histologic description pertaining to small superficial biopsies such as those obtained endoscopically. We report a unique case of a 4 cm transmural cavernous hemangioma in the terminal ileum with literature review and describe a new histologic finding—the “endothelialized muscularis mucosae,” which was discovered upon review of the endoscopic biopsy and could potentially facilitate preoperative diagnosis of these lesions from endoscopic biopsies in the future. These lesions have classically required surgical resection in order to make a definitive diagnosis and rule out malignancy, with which they share many historical and radiographic features. Due to their potential to cause bowel obstruction, intussusception, perforation, and hemorrhage, these lesions may ultimately require surgical resection to relieve symptoms or prevent or treat complications—however, surgical planning and patient counseling could be greatly improved by a preoperative diagnosis. Therefore, gastroenterologists, pathologists, and surgeons should be aware of the “endothelialized muscularis mucosae” which can be very helpful in diagnosing GI cavernous hemangiomas from endoscopic biopsies.

A COMPARATIVE STUDY OF HUMAN PANCREAS WITH OTHER MAMMALIAN PANCREAS

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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

[A Two-Stage Right Hemicolectomy Case in Which the First Surgery Was Laparoscopic Ileocecal Resection Based on Preoperative Diagnosis of Acute Appendicitis].

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Kataoka, Satoshi; Naito, Kei; Miyagawa, Koji; Ishihara, Yosuke; Fuji, Nobuaki

2017-11-01

We report a case oftwo -stage right hemicolectomy in which the first surgery performed was laparoscopic ileocecal resection based on the preoperative diagnosis ofacute appendicitis. The second surgery was performed based on pathological diagnosis ofadvanced cecal cancer accompanied by appendicitis. A 49-year-old woman came to our hospital with a chief complaint of abdominal pain in the lower quadrant for 1 week. Blood test results indicated an inflammatory response, with white blood cells at 10,000/mL and C-reactive protein of1 7.5mg/dL. Abdominal computed tomography showed a swollen appendix and increased uptake in adipose tissue around the appendix. The patient was diagnosed with acute appendicitis, and emergency laparoscopic surgery was performed. Because the cecum wall was thickened and formed an inflammatory mass, ileocecal resection was performed. The pathological diagnosis was advanced cecal cancer accompanied by appendicitis, with metastasis to lymph node No. 201; thus, right hemicolectomy and D3 dissection were performed 14 days after the first surgery. No tumor was found in additional resected tissues. The final diagnosis was cecal cancer: adenocarcinoma tub1, SE, N1, M0, Stage III a. The patient received adjuvant chemotherapy with XELOX and remains relapse free. Acute appendicitis is induced by certain mechanisms that cause appendiceal obstruction. Unlike young patients, middle-aged and elderly patients rarely develop acute appendicitis because ofa tumor causing appendiceal obstruction, which often makes preoperative or perioperative diagnosis difficult. The presence of cancer, such as cecal cancer, should be considered when appendicitis is accompanied by severe inflammation in elderly patients.

Can intraductal ultrasonography (IDUS) predicting the longitudinal extension of intraductal papillary mucinous tumor (IPMT) of the pancreas?

International Nuclear Information System (INIS)

Cho, Young Deok; Jang, Jae Young; Cheon, Young Koog; Moon, Jung Ho; Kim, Yun Soo; Lee, Moon Sung; Hur, Kyung Yul; Shim, Chan Sup

2002-01-01

The treatment of the choice of IPMT is a partial pancreatic resection with complete excision of this potentially malignant lesion, thus preserving sufficient pancreatic tissue to ensure endocrine and exocrine functions. This strategy, however, requires a reliable preoperative assessment of the highly variable extension of IPMT. We performed this study to determine the role of intraductal ultrasonography (IDUS) in predicting extension of IPMT and selecting the resection methods of pancreas. From January 1997 to August 2001, there were 12 consequent patients, including 5 men and 7 women, with a median age of 54 years (range, 37-66) who underwent a resection of IPMT. A preoperative assessment of IPMT by IDUS was performed in all patients. According to the preoperative localization of IPMT by IDUS, various type of limited pancreatic resections were planned. The frozen sectional histologic examination of pancreatic cut surface was performed in all patient. In the case of cut surface tumor positive, a modification of the planned resection was done.

Deep convolutional networks for pancreas segmentation in CT imaging

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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.

Technetium tc 99m-labeled red blood cells in the preoperative diagnosis of cavernous hemangioma and other vascular orbital tumors.

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Polito, Ennio; Burroni, Luca; Pichierri, Patrizia; Loffredo, Antonio; Vattimo, Angelo G

2005-12-01

To evaluate technetium Tc 99m (99mTc) red blood cell scintigraphy as a diagnostic tool for orbital cavernous hemangioma and to differentiate between orbital masses on the basis of their vascularization. We performed 99mTc red blood cell scintigraphy on 23 patients (8 female and 15 male; mean age, 47 years) affected by an orbital mass previously revealed with computed tomography (CT) and magnetic resonance imaging (MRI) and suggesting cavernous hemangioma. In our diagnosis, we considered the orbital increase delayed uptake with the typical scintigraphic pattern known as perfusion blood pool mismatch. The patients underwent biopsy or surgical treatment with transconjunctival cryosurgical extraction when possible. Single-photon emission tomography (SPET) showed intense focal uptake in the orbit corresponding to radiologic findings in 11 patients who underwent surgical treatment and pathologic evaluation (9 cavernous hemangiomas, 1 hemangiopericytoma, and 1 lymphangioma). Clinical or histologic examination of the remaining 22 patients revealed the presence of 5 lymphoid pseudotumors, 2 lymphomas, 2 pleomorphic adenomas of the lacrimal gland, 1 astrocytoma, 1 ophthalmic vein thrombosis, and 1 orbital varix. The confirmation of the preoperative diagnosis by 99mTc red blood cell scintigraphy shows that this technique is a reliable tool for differentiating cavernous hemangiomas from other orbital masses (sensitivity, 100%; specificity, 86%) when ultrasound, CT, and MRI are not diagnostic. Unfortunately, 99mTc red blood cell scintigraphy results were positive in 1 patient with hemangiopericytoma and 1 patient with lymphangioma, which showed increased uptake in the lesion on SPET images because of the vascular nature of these tumors. Therefore, in these cases, the SPET images have to be integrated with data regarding clinical preoperative evaluation and CT scans or MRI studies. On the basis of our study, a complete diagnostic picture, CT scans or MRI studies, and

Well differentiated endocrine carcinomas of the pancreas

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Čolović Radoje

2011-01-01

Full Text Available Introduction. For the difference from poorly differentiated, well differentiated endocrine carcinomas of the pancreas are the tumours in whom with aggressive surgery and chemotherapy fair results can be achieved. Objective. The aim of the study was to point out the importance of such treatment. Methods. Over a 6-year period eight patients (seven female and one male of average age 51 years (ranging from 23 to 71 years were operated on for well differentiated endocrine carcinoma: six of the head and two of the tail of the pancreas. There were two functional and six nonfunctional tumours. Pain in the upper part of the abdomen in seven, mild loss in weight in two, strong heartburn in two, obstructive jaundice in three, diarrhoea in one, sudden massive bleeding from gastric varicosities due to prehepatic portal hypertension caused by pancreatic head tumour in one, and bruise in one patient were registered preoperatively. US and CT in all, angiography in one, octreoscan in two and PET scan in one patient were performed. Whipple’s procedure was performed in six and distal pancreatectomy in two patients, as well as systemic lymphadenectomy in all and excision of liver secondary tumours in two patients. In the patient with massive gastric bleeding a total gastrectomy was performed first, followed by Whipple’s procedure a month later. Results. R0 resection was achieved in all patients. Lymph nodes metastases were found in six patients. Six patients were given chemotherapy. One patient died 3 years after surgery, seven are still alive, on average 2.5 years. A local recurrence after distal pancreatectomy that occurred 5 years after surgery was successfully reresected and the patient is on peptide-receptor radiotherapy. In other six patients there were no local recurence or distant metastases. Conclusion. With aggressive surgery and chemotherapy fair results can be achieved in well differentiated endocrine carcinomas of the pancreas.

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.

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

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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.

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

International Nuclear Information System (INIS)

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

1987-01-01

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

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

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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

Solid pseudopapillary tumor of pancreas with sickle cell trait: A rare case report

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Harish S Permi

2013-01-01

Full Text Available Solid pseudopapillary tumor of pancreas is a rare pancreatic neoplasm affecting young women, has low malignant potential and amenable for surgical excision with good long-term survival. Sickle cell trait is benign condition, which involves one normal beta-globin chain and one HbS chain. Although it is a benign condition, individuals are prone to have rare complications that may predispose to death under certain circumstances. We report a rare coexistence of solid pseudopapillary tumor of pancreas with sickle cell trait in an 18-year-old female who underwent distal pancreatectomy with splenectomy. Histopathological examination and haemoglobin electrophoresis confirmed the diagnosis.

The pancreas from Aristotle to Galen.

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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

The utility of preoperative acth/cortisol ratio for the diagnosis and prognosis of cushing's disease

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Alev Selek

2018-01-01

Full Text Available Purpose: Cushing's syndrome (CS is a rare disease having diagnostic difficulties. Many diagnostic tests have been defined but none of these are diagnostic alone. Determination of the cause is another problem which sometimes requires more sophisticated and invasive procedures. Therefore, we aimed to evaluate the utility of pretreatment plasma adrenocorticotropic hormone (ACTH/cortisol ratios in patients with confirmed endogenous CS for the diagnosis and differential diagnosis of CS. Materials and Methods: This retrospective evaluation included 145 patients with the diagnosis of CS, 119 patients with Cushing's disease (CD, and 26 patients with ACTH-independent CS (AICS, in a university hospital. Furthermore, 114 individuals in whom CS diagnosis was excluded with at least one negative screening test were enrolled to the study as control group. The clinical, laboratory, imaging, postsurgical pathologic records and also clinical follow-up data of all patients were evaluated. Results: The median basal ACTH/cortisol ratio of the patients with CD was significantly higher than AICS and controls. A cutoff ACTH/cortisol ratio >2.5 was found to be diagnostic for CD with 82% specificity and 63% sensitivity. Among CD group, patients with recurrent disease had higher preoperative ACTH levels and ACTH/cortisol ratio than patients with sustained remission. Furthermore, these patients had more invasive, atypical, and larger tumors. Conclusion: An ACTH/cortisol ratio >2.5 would be beneficial to diagnose CD together with other diagnostic tests. It is a simple test with no additional cost. Higher ratios might be related with larger, invasive, and atypical adenoma and also might be helpful to predict recurrence.

Failure to recognize preoperatively high-risk endometrial carcinoma is associated with a poor outcome.

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Di Cello, Annalisa; Rania, Erika; Zuccalà, Valeria; Venturella, Roberta; Mocciaro, Rita; Zullo, Fulvio; Morelli, Michele

2015-11-01

To evaluate the misdiagnosis between endometrial biopsy and definitive surgical pathology and to assess whether the failure in recognizing preoperatively high-risk endometrial carcinoma (EC) can impact oncological outcomes. A retrospective study was conducted to evaluate patients with EC diagnosed by preoperative endometrial biopsy who subsequently underwent surgical staging between 2006 and 2013 at our institution. In patients with a surgical diagnosis of high-risk EC, histotype and grade change between the endometrial biopsy and surgical specimen (discordance diagnosis) were evaluated and correlated to survival outcomes. Cox's regression model for multivariable analysis was used to evaluate the effect of several variables (age, stage, discordance in diagnosis, co-morbidities, frozen section, extensive surgical staging and adjuvant chemotherapy) on the survival rate. Data from 447 patients were reviewed. Among 109 women with surgical diagnosis of high-risk EC, 35 (32.1%) were preoperatively misdiagnosed. Of these 35 women, 24 (68.6%) cases were upgraded to grade 3, and 11 (3.4%) were upgraded to serous or clear cell type in the definitive specimen. The 5-year overall survival (OS; 70.2 vs. 86.8%; p=0.029), disease-specific survival (DSS; 72.5 vs. 88.2%; p=0.039) and recurrence free survival (RFS; 62.6 vs. 82.5%; p=0.024) were significantly lower in the high-risk EC patients who were preoperatively undiagnosed in the endometrial biopsy compared with patients with an appropriate preoperative histological diagnosis. Controlling for age, stage, co-morbidities, frozen section, extensive surgical staging and adjuvant chemotherapy, multivariable analysis revealed that discordance in diagnosis was associated with poorer survival outcomes. Failure to recognize preoperatively high-risk ECs is associated with worse outcomes. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

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)

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

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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

Neuroendocrine tumors of the pancreas; Multimodale Bildgebung bei neuroendokrinen Tumoren des Pankreas

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Holzapfel, Konstantin; Rummeny, Ernst J. [Technische Univ. Muenchen (Germany). Inst. fuer Radiologie; Gaertner, Florian C. [Technische Univ. Muenchen (Germany). Nuklearmedizinische Klinik

2011-12-15

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.)

Giant serous microcystic pancreas adenoma

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Mustafa Kerem

2012-10-01

Full Text Available Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11x9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12x11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pan creatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient’s symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases.

Assessment of pancreas cells

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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.

Ultrasound-guided biopsy of transplanted pancreas: evaluation of 20 cases

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Marcel Vieira da Nóbrega

2009-03-01

Full Text Available Objective: To report the experience with percutaneous biopsies of pancreatic grafts guided by ultrasonography. Methods: Series of cases referred from outpatient’s clinic for biopsy of pancreas transplant, between December 2006 and March 2008. Data were collected from medical electronic records for age, sex and histopathology. The indication for the procedure was obtained from medical and laboratory records. Doppler ultrasonography was performed for control and to guide biopsy in real time. Rresults: Twenty patients referred for biopsy of their transplanted pancreas over a one-year period were evaluated. In one patient, biopsy was not performed for having no safe access for ultrasound. It was used 18 gauge needles, mostly automatic-cut type. The main indications were increased blood glucose and pancreatic enzyme levels as well as reduction of urinary amylase. The sonographic aspect of the pancreatic graft was normal in 18 cases. In all 19 biopsies performed, satisfactory samples for histopathological study were obtained. There were no complications. Cconclusions: This series of cases demonstrated low sensitivity and specificity of ultrasound in diagnosis of pancreatic transplants disorders, but showed to be very useful to guide transplanted pancreas biopsies. Although no complications occurred in this experience, the risk-benefit relation should always be assessed for every patient.

Diagnosis and treatment of solid pseudopapillary tumor of the pancreas: experience of one single institution from Turkey

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2013-01-01

Background Solid pseudopapillary neoplasia (SPN) of the pancreas is an extremely rare epithelial tumor of low malignant potential. SPN accounts for less than 1% to 2% of exocrine pancreatic tumors. The aim of this study is to report our experience with SPN of the pancreas. It includes a summary of the current literature to provide a reference for the management of this rare clinical entity. Methods A retrospective analysis was performed of all patients diagnosed and treated for SPN in our hospital over the past 15 years (1998 to 2013). A database of the characteristics of these patients was developed, including age, gender, tumor location and size, treatment, and histopathological and immunohistochemical features. Results During this time period, 255 patients with pancreatic malignancy (which does not include ampulla vateri, distal choledocal and duodenal tumor) were admitted to our department, only 10 of whom were diagnosed as having SPN (2.5%). Nine patients were women (90%) and one patient was a man (10%). Their median age was 38.8 years (range 18 to 71). The most common symptoms were abdominal pain and dullness. Seven patients (70%) presented with abdominal pain or abdominal dullness and three patient (30%) were asymptomatic with the diagnosis made by an incidental finding on routine examination. Abdominal computed tomography and/or magnetic resonance imaging showed the typical features of solid pseudopapillary neoplasm in six (60%) of the patients. Four patients underwent distal pancreatectomy with splenectomy, one patient underwent a total mass excision, and one patient underwent total pancreatic resection. Two required extended distal pancreatectomy with splenectomy. Two underwent spleen-preserving distal pancreatectomy. Conclusions SPN is a rare neoplasm that primarily affects young women. The prognosis is favorable even in the presence of distant metastasis. Although surgical resection is generally curative, a close follow-up is advised in order to

Genetics Home Reference: Pearson marrow-pancreas syndrome

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... 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 ...

Malignant fibrous histiocytoma of pancreas: presentation of a case

International Nuclear Information System (INIS)

Garcia Sanchez, M.A.; Serrano Gotarredona, M.P.; Fernandez-Cruz, J.; Marrero Calvo, S.

1995-01-01

We present a case of malignant fibrous histiocytoma (MFH) located in the body and tail of the pancreas of a 60-year-old woman. The mass was large, lobulated and well delimited by a pseudocapsule. Pancreatectomy involving the body and tail and splenectomy were performed and the diagnosis was reached on the basis of pathological and immunohistochemical studies. The course was aggressive with local recurrence and liver metastases presenting two months after the operation. The computerized tomography (CT) findings are provided. (Author)

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

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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.

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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

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.

[Insulinoma of the pancreas: analysis of a clinical series of 30 cases].

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Andronesi, D; Andronesi, A; Tonea, A; Andrei, S; Herlea, V; Lupescu, I; Ionescu-Târgovişte, C; Coculescu, M; Fica, S; Ionescu, M; Gheorghe, C; Popescu, I

2009-01-01

Insulinoma is the most frequent neuroendocrine pancreatic tumor and is the main cause for hypoglicemia due to endogenous hyperinsulinism. We performed an analysis of a clinical series in order to study the clinical and biological spectrum of presentation, the preoperatory imagistic diagnosis and results of the surgical approach. Between 1986-2009, 30 patients with symptoms suggesting an insulinoma were hospitalized in our department. Preoperatory localization of insulinomas was possible in 16 patients. The most sensitive imagistic methods were ecoendoscopy and magnetic resonance. Intraoperatory ultrasound was performed in 16 patients and its sensitivity in detection of insulinomas was 93%; the combination between intraoperative ultrasound and manual exploration of pancreas by the surgeon reached a 100% sensitivity. Before the intraoperatory ultrasound was used the tumor excision was predominantly done by extensive pancreatic resection, while after this was available in our centre more conservative (enucleo-resection) procedures were chosen. In 1 patient the resection was done by laparoscopy, and in 1 patient by robotic surgery. The dimensions of the tumor were less than 2 cm in most of the patients; 2 had nesidioblastosis and 2 had multiple insulinomas; all 28 patients proved to have benign insulinomas at histological specimens. Following surgery, the symptoms disappear in all patients. The most common complication following extensive pancreatic resections was acute pancreatitis, while after enucleation pancreatic fistula occurred more frequently. Due to small dimensions, the preoperative diagnosis of insulinomas is usually difficult, ecoendoscopy being the most sensitive method. Intraoperative ultrasound is essential for insulinoma localization and for chosing the optimal type of excision. Enucleation is the resection method to be chosen whenever this it is technical possible. In benign insulinomas the prognosis is excellent, surgical resection being curative in

Pancreas preserving total duodenectomy for complex duodenal injury.

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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.

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.

An improved method for pancreas segmentation using SLIC and interactive region merging

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Zhang, Liyuan; Yang, Huamin; Shi, Weili; Miao, Yu; Li, Qingliang; He, Fei; He, Wei; Li, Yanfang; Zhang, Huimao; Mori, Kensaku; Jiang, Zhengang

2017-03-01

Considering the weak edges in pancreas segmentation, this paper proposes a new solution which integrates more features of CT images by combining SLIC superpixels and interactive region merging. In the proposed method, Mahalanobis distance is first utilized in SLIC method to generate better superpixel images. By extracting five texture features and one gray feature, the similarity measure between two superpixels becomes more reliable in interactive region merging. Furthermore, object edge blocks are accurately addressed by re-segmentation merging process. Applying the proposed method to four cases of abdominal CT images, we segment pancreatic tissues to verify the feasibility and effectiveness. The experimental results show that the proposed method can make segmentation accuracy increase to 92% on average. This study will boost the application process of pancreas segmentation for computer-aided diagnosis system.

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.

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)

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.)

Double labelling scintigraphy in the diagnosis of pancreatic neoplasms

International Nuclear Information System (INIS)

Codin, Rene.

1975-01-01

Experiences in pancreas scanning using 75 Se-selenomethionie, performed for three years in a medical center, are reported. The principle of selenomethionine uptake is described. This indicator, though preferential, is far from ideal as its hepatic tropism prevents its use in pancreas scintigraphy unless steps are taken to eliminate the liver image. The dual-isotope subtraction technique (sup(99m)Tc+ 75 Se) is used to solve this problem. A gamma camera is coupled to a computer for data processing. The results and advantages of this technique in the diagnosis of carcinomas of the pancreas are discussed [fr

Solid Pseudopapillary Neoplasm of the Pancreas in Young Male Patients: Three Case Reports

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Akira Aso

2017-01-01

Full Text Available A preoperative diagnosis of solid pseudopapillary neoplasms (SPNs in young male patients is difficult to achieve using radiological images. We herein present three cases of young male patients with relatively small SPNs. Endoscopic ultrasound (EUS showed well-encapsulated, smooth-surfaced, heterogeneous solid lesions in all patients, and all preoperative diagnoses were achieved by EUS-guided fine needle aspiration (EUS-FNA. The final pathological diagnosis after surgery was an SPN with a Ki-67 labeling index of <2%. SPNs should be considered even in young male patients. EUS with EUS-FNA could be a useful diagnostic modality for SPNs even in young male patients.

FDG-PET for preoperative differential diagnosis between benign and malignant soft tissue masses

International Nuclear Information System (INIS)

Aoki, J.; Koyama, Y.; Sato, N.; Watanabe, H.; Shinozaki, T.; Takagishi, K.; Tokunaga, M.; Endo, K.

2003-01-01

To evaluate the standardized uptake value (SUV) of [ 18 F]2-deoxy-2-fluoro-d-glucose at positron emission tomography (FDG-PET) for preoperative differential diagnosis between benign and malignant soft tissue masses.Design One hundred and fourteen soft tissue masses (80 benign, 34 malignant) were examined by FDG-PET prior to tissue diagnosis. The SUVs were calculated and compared between benign and malignant lesions and among different histologic subgroups which included three or more cases. There was a statistically significant difference in SUV between benign (1.80±1.42 [SD]) and malignant (4.20±3.16) soft tissue masses in total (P<0.0001). However, a considerable overlap in SUV was observed between many benign and malignant lesions. Liposarcomas (2.16±1.72) and synovial sarcomas (1.60±0.43) did not show significantly higher SUV than any benign lesions. Metastases (4.23±2.35) showed no statistically significant difference in SUV as compared with schwannomas (1.75±0.84), desmoids (2.77±1.32), sarcoidosis (3.62±1.53), or giant cell tumors of tendon sheath (GCT of TS; 5.06±1.63). Even malignant fibrous histiocytomas (5.37±1.40) could not be differentiated from sarcoidosis or GCT of TS, based on the SUV. A large accumulation of FDG can be observed in both benign and malignant histiocytic, fibroblastic, or neurogenic lesions. SUV at conventional FDG-PET is limited to differentiating benign from malignant soft tissue masses, when all kinds of histologic subtypes are included. (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.

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.)

Combined resection of aberrant right hepatic artery without anastomosis in panceaticoduodenectomy for pancreatic head cancer: A case report.

Science.gov (United States)

Nanashima, Atsushi; Imamura, Naoya; Tsuchimochi, Yuki; Hiyoshi, Masahide; Fujii, Yoshiro

2016-01-01

This case report is intended to inform pancreas surgeons of our experience in operative management of aberrant pancreatic artery. A 63-year-old woman was admitted to our institute's Department of Surgery with obstructive jaundice, and the pancreas head tumor was found. To improve liver dysfunction, an endoscopic retrograde nasogastric biliary drainage tube was placed in the bile duct. Endoscopic fine-needle aspiration showed a pancreas head carcinoma invading the common bile duct, the aberrant right hepatic artery arising from the superior mesenteric artery, and the portal vein. Enhanced computed tomography showed the communicating artery between the right and left hepatic artery via the hepatic hilar plate. By way of imaging preoperative examination, a pancreaticoduodenectomy combined resection of the aberrant right hepatic artery and portal vein was conducted without arterial anastomosis. Hepatic arterial flow was confirmed by intraoperative Doppler ultrasonography, and R0 resection without tumor exposure at the dissected plane was achieved. The patient's postoperative course was uneventful. In this case report, perioperative detail examination by imaging diagnosis with respect to hepatic arterial communication to achieve curative resection in a pancreas head cancer was necessary. Non-anastomosis of hepatic artery was achieved, and the necessity of R0 resection was stressed by such management. By the preoperative and intraoperative imaging managements conducted, combined resection of the aberrant right hepatic artery without anastomosis was achieved by pancreaticoduodenectomy for pancreas head cancer. However, improvements in imaging diagnosis and careful management of R0 resection are important. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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.

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

Nephroblastoma with right atrial extension: preoperative diagnosis and management.

Science.gov (United States)

Vaughan, E D; Crosby, I K; Tegtmeyer, C J

1977-04-01

A 14-year-old black boy, with a large nephroblastoma of the right kidney, had preoperative identification of inferior vena cava and right atrial involvement. Renal arteriography revealed linear arterial channels in the anatomic distribution of the inferior vena cava and venography revealed total caval occlusion and a right atrial mass. Radical excision, using a cardiopulmonary bypass, resulted in a 6-month postoperative survival.

Laparoscopic removal of a needle from the pancreas

Directory of Open Access Journals (Sweden)

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.

Magnetic resonance imaging in the diagnosis of pancreatic diseases

International Nuclear Information System (INIS)

Yamaguchi, Taketo; Ebara, Masaaki; Saisho, Hiromitsu

1987-01-01

Fifty patients with various pancreatic diseases and 22 without pancreatic disease were studied by a magnetic resonance imaging (MRI) to compare its diagnostic capability with that by an X-ray CT scan. To differentiate pancreas clearly from the bowel, an iron solution was orally administered as contrast medium, resulting in a usefullness, especially to differentiate the head of the pancreas from the bowel. The head of the pancreas could be identified in 89 % after iron solution but only in 62 % without it. MRI was inferior to CT in terms of visualization of the pancreatic duct and pancreatic stones, but was superior in a visualization of vessels around the pancreas. MRI was considered to be useful for a detection of carcinoma infiltrating to vessels. Pancreatic carcinoma was differentiated from chronic pancreatitis in terms of a local enlargement and disappearance of fat around the pancreas shown on MRI findings. The present results also showed statistically significant differences in T 1 relaxation times among normal pancreas, chronic pancreatitis and pancreatic carcinoma, suggesting a useful marker in the differential diagnosis of pancreatic diseases. (author)

Accuracy of preoperative diagnosis for primary hyperparathyroidism by CT, US and scintigraphy

International Nuclear Information System (INIS)

Imada, Masanobu; Nonaka, Satoshi; Hayashi, Tatsuya; Kunibe, Isamu; Harabuchi, Yasuaki

2003-01-01

We determined the usefulness of computed tomography (CT), ultrasonography (US) and Tc-Tl subtraction scintigraphy for preoperative diagnosis in 12 patients with primary hyperparathyroidism, all of which were solitary adenoma. Seven (63.6%) of 11 tumors were detected by CT, 7 (58.3%) of 12 tumors were detected by US, and 7 (63.6%) of 11 tumors were detected by Tc-Tl subtraction scintigraphy. Of 7 tumors with size>10 mm, 6 (85.7%) were detected by CT, 5 (71.4%) were detected by US, and 6 (85.7%) were detected by Tc-Tl subtraction scintigraphy, whereas only 1 (25%) with a diameter of 10 mm was detected by each of CT or Tc-Tl subtraction scintigraphy and 2 (40%) with diameters 10 mm were detected by US. Of 6 tumors situated behind the thyroid gland or intra thyroid gland, 5 (83.3%) were detected by CT and all 6 (100%) were detected by US, Tl-Tc subtraction scintigraphy, which was employed for 5 tumors, detected all 5 (100%). However, in the tumors situated beneath the thyroid gland only 2 (40%) of 5, 1 (16.7%) of 6 and 2 (33.3%) of 6 were detected by CT, US and Tc-Tl subtraction scintigraphy respectively. In 5 tumors without thyroid disease, 4 (80%) of 5 were detected by both CT and US, 3 (75%) of 4 were detected by Tc-Tl subtraction scintigraphy. However, in 7 tumors with thyroid diseases (papillary carcinoma, follicular carcinoma, follicular adenoma, chronic thyroiditis, and adenomatous goiter), 3 (50%) of 6 were detected by CT, 3 (42.9%) of 7 were detected by US and 4 (57.1%) of 7 were detected by Tc-Tl subtraction scintigraphy. Location of tumor was the factor most likely to make appropriate diagnosis difficult for primary hyperparathyroidism by any assessment method. (author)

[Value of preoperative barium contrast examination for the diagnosis and operative planning in gastric cancer].

Science.gov (United States)

Wang, Chang-jian; Zhao, Guang-fa; Li, Qing-guo; Chen, Jing-gui; Zhu, Kai; Shi, Ying-qiang; Fu, Hong

2010-04-01

To investigate the value of preoperative barium contrast examination for the diagnosis and operative planning in gastric cancer. Clinical data of 229 gastric cancer patients were analyzed retrospectively. Lesions were divided into three parts: the cardiac, the body, and the antrum. The diagnostic accuracy of localization and the extent of tumor between gastroscopy alone and gastroscopy plus barium contrast were compared with the results of surgical findings. The diagnostic accuracy of localization and the extent of tumor for gastroscopy in the cardiac, the body and the antrum cancers were 100% and 78.4%, 94.6% and 86.5%, 98.1% and 84.6%, respectively, while for gastroscopy plus barium contrast were 100% and 84.8%, 100% and 91.9%, 99.0% and 90.4%, respectively. The diagnostic accuracy of both the localization and the extent of tumor were not significantly different between gastroscopy alone and gastroscopy plus barium contrast (P>0.05). Diagnostic accuracy of the length of esophagus infiltrated by cardiac cancer in gastroscopy was 60.6%, while in gastroscopy plus barium contrast was 90.9%, which was significantly different (Pbarium contrast was more accurate in predicting the possibility of thoracotomy in cardiac cancer infiltrating the lower esophagus. It is necessary to perform preoperative barium contrast examination in cardiac cancer patients, so as to identify whether the lower esophagus is infiltrated and to measure the length of lesion, which can provide evidences for making a decision of thoracotomy. For gastric body and antrum cancer, there is no indication for barium contrast examination if gastroscopy findings are satisfied.

Preoperative embolization in surgical treatment of spinal metastases

DEFF Research Database (Denmark)

Clausen, Caroline; Dahl, Benny; Frevert, Susanne Christiansen

2015-01-01

PURPOSE: To assess whether preoperative transcatheter arterial embolization of spinal metastases reduces blood loss, the need for transfusion with allogeneic red blood cells (RBCs), and surgery time in the surgical treatment of patients with symptomatic metastatic spinal cord compression. MATERIALS......L) versus 902 mL (SD, 416 mL). CONCLUSIONS: Preoperative embolization in patients with symptomatic spinal metastasis independent of primary tumor diagnosis did not reduce intraoperative blood loss and allogeneic RBC transfusion significantly but did reduce the surgery time. A small reduction...... instrumentation and randomly assigned to either preoperative embolization (n = 23) or a control group (n = 22). The primary outcome was intraoperative blood loss. Secondary outcomes were perioperative blood loss, allogeneic RBC transfusion, and surgery time. Analyses were performed by intention-to-treat. RESULTS...

Agenesis of the dorsal pancreas: a rare cause of insulin-dependent diabetes without abdominal pain: Case report.

Science.gov (United States)

Liang, Kaiyong; Ou, Xiaojuan; Huang, Xukai; Lan, Qunfang

2018-03-01

Agenesis of the dorsal pancreas is a very rare condition with an unknown pathology and etiology, although it may be associated with autosomal dominant or X-linked dominant inheritance or retinoic acid and hedgehog signaling pathway alterations. This condition usually manifests with abdominal pain or pancreatitis, although some cases are asymptomatic. Approximately 50% of affected patients with this disorder present with hyperglycemia or various other anomalies. We report the case of a 23-year-old Chinese woman who visited the Department of Endocrinology and Metabolism with insulin-dependent diabetes but no specific symptoms, signs, or other deformities. Severe diabetic retinopathy indicated a long period of hyperglycemia. Agenesis of the dorsal pancreas was observed incidentally during the common diagnosis of diabetes, and the diagnosis was established using magnetic resonance imaging, diffusion-weighted imaging, and magnetic resonance cholangiopancreatography. Following the diagnosis of diabetes, insulin replacement therapy was initiated at a dosage of up to 45 U per day. The patient's blood glucose level was monitored, and the insulin dosage was adjusted accordingly. The patient's blood glucose levels gradually normalized after insulin treatment and were subsequently maintained with intensive insulin therapy. Treatment for diabetic retinopathy was provided by the Ophthalmology Department. Agenesis of the dorsal pancreas should be considered in a young patient diagnosed with diabetes who presents with obvious diabetes-related complications (e.g., renal, retinal, or neurological) inconsistent with the course of the disease or a history of other congenital anomalies. We recommend the routine use of computed tomography or magnetic resonance imaging when examining young patients with diabetes.

Reconstituting development of pancreatic intraepithelial neoplasia from primary human pancreas duct cells

OpenAIRE

Lee, Jonghyeob; Snyder, Emily R.; Liu, Yinghua; Gu, Xueying; Wang, Jing; Flowers, Brittany M.; Kim, Yoo Jung; Park, Sangbin; Szot, Gregory L.; Hruban, Ralph H.; Longacre, Teri A.; Kim, Seung K.

2017-01-01

Development of systems that reconstitute hallmark features of human pancreatic intraepithelial neoplasia (PanINs), the precursor to pancreatic ductal adenocarcinoma, could generate new strategies for early diagnosis and intervention. However, human cell-based PanIN models with defined mutations are unavailable. Here, we report that genetic modification of primary human pancreatic cells leads to development of lesions resembling native human PanINs. Primary human pancreas duct cells harbouring...

Adult Intussusception Caused by Heterotopic Pancreas

Directory of Open Access Journals (Sweden)

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

Directory of Open Access Journals (Sweden)

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

Cost-effectiveness of using a molecular diagnostic test to improve preoperative diagnosis of thyroid cancer.

Science.gov (United States)

Najafzadeh, Mehdi; Marra, Carlo A; Lynd, Larry D; Wiseman, Sam M

2012-12-01

Fine-needle aspiration biopsy (FNAB) is a safe and inexpensive diagnostic procedure for evaluating thyroid nodules.Up to 25% of the results from an FNAB, however, may not be diagnostic or may be indeterminate, leading to a subsequent diagnostic thyroid surgery. A new molecularly based diagnostic test could potentially reduce indeterminate cytological results and, with high accuracy, provide a definitive diagnosis for cancer in thyroid nodules. The aim of the study was to estimate the cost-effectiveness of utilizing a molecular diagnostic (DX) test as an adjunct to FNAB, compared with NoDX, to improve the preoperative diagnosis of thyroid nodules. We constructed a patient-level simulation model to estimate the clinical and economic outcomes of using a DX test compared with current practice (NoDX) for the diagnosis of thyroid nodules. By using a cost-effectiveness framework, we measured incremental clinical benefits in terms of quality-adjusted life-years and incremental costs over a 10-year time horizon. Assuming 95% sensitivity and specificity of the Dx test when used as an adjunct to FNAB, the utilization of the DX test resulted in a gain of 0.046 quality-adjusted life-years (95% confidence interval 0.019-0.078) and a saving of $1087 (95% confidence interval $691-$1533) in direct costs per patient. If the cost of the Dx test is less than $1087 per test, we expect to save quality-adjusted life-years and reduce costs when it is utilized. Sensitivity of the DX test, compared with specificity, had a larger influence on the overall outcomes. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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)

Necrotizing fasciitis: unreliable MRI findings in the preoperative diagnosis

Energy Technology Data Exchange (ETDEWEB)

Arslan, Arzu E-mail: arzuarslan@netscape.net; Pierre-Jerome, Claude; Borthne, Arne

2000-12-01

The authors present two cases of necrotizing fasciitis (NF), one case of dermatomyositis and one case of posttraumatic muscle injury, which have similar magnetic resonance imaging findings in terms of skin, subcutaneous fat, superficial and deep fasciae and muscle involvement. These cases highlight the need for cautious interpretation of magnetic resonance imaging (MRI) findings, for they are nonspecific and the preoperative decision should be based mostly on the evolution of the clinical status.

Acute gallbladder torsion - a continued pre-operative diagnostic dilemma

Directory of Open Access Journals (Sweden)

Desrochers Randal

2011-04-01

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

Beta-Cell Replacement: Pancreas and Islet Cell Transplantation.

Science.gov (United States)

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.

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.

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

SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION: EARLY POSTOPERATIVE COMPLICATIONS

Directory of Open Access Journals (Sweden)

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)

Pancreas segmentation from 3D abdominal CT images using patient-specific weighted subspatial probabilistic atlases

Science.gov (United States)

Karasawa, Kenichi; Oda, Masahiro; Hayashi, Yuichiro; Nimura, Yukitaka; Kitasaka, Takayuki; Misawa, Kazunari; Fujiwara, Michitaka; Rueckert, Daniel; Mori, Kensaku

2015-03-01

Abdominal organ segmentations from CT volumes are now widely used in the computer-aided diagnosis and surgery assistance systems. Among abdominal organs, the pancreas is especially difficult to segment because of its large individual differences of the shape and position. In this paper, we propose a new pancreas segmentation method from 3D abdominal CT volumes using patient-specific weighted-subspatial probabilistic atlases. First of all, we perform normalization of organ shapes in training volumes and an input volume. We extract the Volume Of Interest (VOI) of the pancreas from the training volumes and an input volume. We divide each training VOI and input VOI into some cubic regions. We use a nonrigid registration method to register these cubic regions of the training VOI to corresponding regions of the input VOI. Based on the registration results, we calculate similarities between each cubic region of the training VOI and corresponding region of the input VOI. We select cubic regions of training volumes having the top N similarities in each cubic region. We subspatially construct probabilistic atlases weighted by the similarities in each cubic region. After integrating these probabilistic atlases in cubic regions into one, we perform a rough-to-precise segmentation of the pancreas using the atlas. The results of the experiments showed that utilization of the training volumes having the top N similarities in each cubic region led good results of the pancreas segmentation. The Jaccard Index and the average surface distance of the result were 58.9% and 2.04mm on average, respectively.

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...

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.

Multimodality Imaging Evaluation of an Uncommon Entity: Esophageal Heterotopic Pancreas

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Takman Mack

2014-01-01

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

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.

Isolated pancreatic hydatid cyst: Preoperative prediction on contrast-enhanced computed tomography case report and review of literature

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Abhijit Rayate

2012-01-01

Full Text Available A primary pancreatic-isolated hydatid cyst, that too in tail of pancreas with no lesion in liver, is a rare presentation of this disease. We report a case of 30-year-old lady presenting with only abdominal pain and on imaging found to be a cystic lesion in tail of pancreas without any liver lesion. Contrast-enhanced computed tomography scan is helpful in diagnosis by identifying the presence of multiloculation, curvilinear calcification, or the presence of daughter cysts. She was successfully treated by distal pancreatectomy without splenectomy.

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.

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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.

Clinical Utility of Preoperative Computed Tomography in Patients With Endometrial Cancer.

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Bogani, Giorgio; Gostout, Bobbie S; Dowdy, Sean C; Multinu, Francesco; Casarin, Jvan; Cliby, William A; Frigerio, Luigi; Kim, Bohyun; Weaver, Amy L; Glaser, Gretchen E; Mariani, Andrea

2017-10-01

The aim of this study was to determine the clinical utility of routine preoperative pelvic and abdominal computed tomography (CT) examinations in patients with endometrial cancer (EC). We retrospectively reviewed records from patients with EC who underwent a preoperative endometrial biopsy and had surgery at our institution from January 1999 through December 2008. In the subset with an abdominal CT scan obtained within 3 months before surgery, we evaluated the clinical utility of the CT scan. Overall, 224 patients (18%) had a preoperative endometrial biopsy and an available CT scan. Gross intra-abdominal disease was observed in 10% and 20% of patients with preoperative diagnosis of endometrioid G3 and type II EC, respectively, whereas less than 5% of patients had a preoperative diagnosis of hyperplasia or low-grade EC. When examining retroperitoneal findings, we observed that a negative CT scan of the pelvis did not exclude the presence of pelvic node metastasis. Alternately, a negative CT scan in the para-aortic area generally reduced the probability of finding para-aortic dissemination but with an overall low sensitivity (42%). However, the sensitivity for para-aortic dissemination was as high as 67% in patients with G3 endometrioid cancer. In the case of negative para-aortic nodes in the CT scan, the risk of para-aortic node metastases decreased from 18.8% to 7.5% in patients with endometrioid G3 EC. Up to 15% of patients with endometrioid G3 cancer had clinically relevant incidental findings that necessitated medical or surgical intervention. In patients with endometrioid G3 and type II EC diagnosed by the preoperative biopsy, CT scans may help guide the operative plan by facilitating preoperative identification of gross intra-abdominal disease and enlarged positive para-aortic nodes that are not detectable during physical examinations. In addition, CT may reveal other clinically relevant incidental findings.

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.)

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.

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

Preoperative risk factors for conversion and learning curve of minimally invasive distal pancreatectomy.

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Hua, Yongfei; Javed, Ammar A; Burkhart, Richard A; Makary, Martin A; Weiss, Matthew J; Wolfgang, Christopher L; He, Jin

2017-11-01

Although laparoscopic distal pancreatectomy is considered a standard approach, 10% to 40% of these are converted. The preoperative risk factors for conversion are not well described. The aim of this study was to identify risk factors associated with conversion. Clinicopathological variables of 211 consecutive patients who underwent laparoscopic distal pancreatectomy between January 2007 and December 2015 at Johns Hopkins were analyzed to identify factors associated with conversion. Furthermore, the learning curve for laparoscopic distal pancreatectomy was studied. On univariate analysis of diabetes mellitus, preoperative diagnosis of malignant disease, multiorgan resection, surgeons' years and case experience were significantly associated with conversion (all P pancreatectomy with a preoperative diagnosis of malignant disease or possible multiorgan resection are at a higher risk of conversion. Surgeon experience of performing >15 procedures significantly reduces the risk of conversion. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

US-guided preoperative hook-wire localization of nonpalpable breast lesions

International Nuclear Information System (INIS)

Shin, Tae Beom; Lee, Sang Kwon; Kim, Hye Jung; Ryeom, Hun Kyu; Kim, Tae Hun; Kim, Yong Ju; Kang, Duk Sik; Lee, Young Ha; Park, Ho Yong

2000-01-01

To evaluate the feasibility and efficacy of US-guided preoperative wire localization of nonpalpable breast lesions. US-guided preoperative wire localization was performed upon 45 nonpalpable breast lesions including 14 nonpalpable masses, 11 nonpalpable masses with microcalcifications, 11 ductal lesions, 9 with microcalcifications. No local anesthesia was performed during the localization procedure. Under the US-guidance, the needle with the hook-wire was inserted into the lesion until the hook of the wire reached 1 cm beyond the posterior margin of the lesion. Precise wire positioning was confirmed by mammography. Specimen radiography or specimen ultrasonography was performed in all cases. US-guided preoperative wire localization was successfully achieved in all cases. The time required for US-guided wire localization was less than five minutes. All lesions were successfully removed by surgical excision. Successful removal was confirmed by specimen radiography or specimen ultrasonography, gross findings of the specimen and consistency between radiographic and pathologic findings. The histologic diagnosis of 45 lesions were 7 ductal carcinoma in situ, 8 invasive ductal carcinoma, 6 fibroadenoma, 8 intraductal papilloma, 2 atypical ductal hyperplasia, and 14 fibrocystic changes. No complications were occurred during and after the procedure. US-guided preoperative wire localization for excisional biopsy is simple, safe, and accurate method in the histologic diagnosis of nonpalpable breast lesions detectable with ultrasonography.

US-guided preoperative hook-wire localization of nonpalpable breast lesions

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Shin, Tae Beom; Lee, Sang Kwon; Kim, Hye Jung; Ryeom, Hun Kyu; Kim, Tae Hun; Kim, Yong Ju; Kang, Duk Sik; Lee, Young Ha; Park, Ho Yong [Kyungpook National University College of Medicine, Taegu (Korea, Republic of)

2000-12-15

To evaluate the feasibility and efficacy of US-guided preoperative wire localization of nonpalpable breast lesions. US-guided preoperative wire localization was performed upon 45 nonpalpable breast lesions including 14 nonpalpable masses, 11 nonpalpable masses with microcalcifications, 11 ductal lesions, 9 with microcalcifications. No local anesthesia was performed during the localization procedure. Under the US-guidance, the needle with the hook-wire was inserted into the lesion until the hook of the wire reached 1 cm beyond the posterior margin of the lesion. Precise wire positioning was confirmed by mammography. Specimen radiography or specimen ultrasonography was performed in all cases. US-guided preoperative wire localization was successfully achieved in all cases. The time required for US-guided wire localization was less than five minutes. All lesions were successfully removed by surgical excision. Successful removal was confirmed by specimen radiography or specimen ultrasonography, gross findings of the specimen and consistency between radiographic and pathologic findings. The histologic diagnosis of 45 lesions were 7 ductal carcinoma in situ, 8 invasive ductal carcinoma, 6 fibroadenoma, 8 intraductal papilloma, 2 atypical ductal hyperplasia, and 14 fibrocystic changes. No complications were occurred during and after the procedure. US-guided preoperative wire localization for excisional biopsy is simple, safe, and accurate method in the histologic diagnosis of nonpalpable breast lesions detectable with ultrasonography.

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

Role of fine needle aspiration cytology in the preoperative investigation of branchial cysts.

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Slater, Jacqueline; Serpell, Jonathan W; Woodruff, Stacey; Grodski, Simon

2012-01-01

Successful preoperative diagnosis of a branchial cyst requires a systematic approach. The aim of this study was to evaluate methods of investigation of a lateral neck swelling suspicious for a branchial cyst, and to highlight cases where a less benign cause for the swelling should be suspected and therefore management altered appropriately. A retrospective case study of 24 patients with presumed branchial cysts managed operatively was undertaken. Demographic, clinical, imaging, cytology and histopathological data were analysed to formulate an approach to the work-up of a lateral neck swelling suspected to be a branchial cyst. All 24 patients presented with a lateral neck mass thought to be a branchial cyst preoperatively underwent preoperative fine-needle aspiration cytology. The overall accuracy of cytology in predicting a benign branchial cyst histopathologically was 83.3% (20 out of 24). Successful preoperative diagnosis of a branchial cyst requires a combination of imaging and cytology. If there is concern that a lateral neck swelling is not a branchial cyst on clinical, imaging or cytological features, then a full preoperative work-up, including computed tomography scan of the neck and upper aero-digestive tract endoscopy should be performed, prior to an excisional biopsy. © 2011 The Authors. ANZ Journal of Surgery © 2011 Royal Australasian College of Surgeons.

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

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Guanà Riccardo

2014-01-01

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

Measure of pancreas transection and postoperative pancreatic fistula.

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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.

Surgical misadventure: A case for thoughtful patient preoperative ...

African Journals Online (AJOL)

An assessment of the psychological impact of losing a breast in this patient was not possible as patient was lost to follow up. Optimal clinical examination by the surgeon and preoperative cytological diagnosis would ensure that the patient is spared unnecessary mutilating surgery. Nigerian Journal of Surgical Research Vol.

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.

Clinical Application of 18F-FDG PET in Pancreas Cancer

International Nuclear Information System (INIS)

Kang, Won Jun

2008-01-01

The prevalence of pancreas cancer is increasing. Due to difficulty in detecting early stage disease, the prognosis of pancreas cancer is known to be poor. Clinical use of FDG PET in pancreas has been reported. FDG PET showed good performance in diagnosing pancreas cancer, and is expected to be useful in staging and detecting recurrence

Jaundice: an important, poorly recognized risk factor for diminished survival in patients with adenocarcinoma of the head of the pancreas

Science.gov (United States)

Strasberg, Steven M; Gao, Feng; Sanford, Dominic; Linehan, David C; Hawkins, William G; Fields, Ryan; Carpenter, Danielle H; Brunt, Elizabeth M; Phillips, Carolyn

2014-01-01

Objectives: Jaundice impairs cellular immunity, an important defence against the dissemination of cancer. Jaundice is a common mode of presentation in pancreatic head adenocarcinoma. The purpose of this study was to determine whether there is an association between preoperative jaundice and survival in patients who have undergone resection of such tumours. Methods: Thirty possible survival risk factors were evaluated in a database of over 400 resected patients. Univariate analysis was used to determine odds ratio for death. All factors for which a P-value of jaundice, age, positive node status, poor differentiation and lymphatic invasion were significant indicators of poor outcome in multivariate analysis. Absence of jaundice was a highly favourable prognostic factor. Interaction emerged between jaundice and nodal status. The benefit conferred by the absence of jaundice was restricted to patients in whom negative node status was present. Five-year overall survival in this group was 66%. Jaundiced patients who underwent preoperative stenting had a survival advantage. Conclusions: Preoperative jaundice is a negative risk factor in adenocarcinoma of the pancreas. Additional studies are required to determine the exact mechanism for this effect. PMID:23600768

Comparison of computerized tomography to sonography, applied in diseases of the pancreas

International Nuclear Information System (INIS)

Kluge, K.

1982-01-01

The examination results of 418 patients whose epigastria had been examined both by computerized tomography and sonography over 1 week in the time from beginning January 1978 until and of July 1979 were compared with regard to the imaging of the pancreas, reliability, and the specificity and sensitivity in establishing the diagnosis. For the sonographic examination, a compound and a real-time unit were used; the computerized tomography was carried out by means of an equipment of the 3rd generation with a scan time of 4 sec. The screening of the pancreas was significantly better using computerized tomography (99.3% US. 84% with US). As for accuracy, computerized tomography had 92.5% exact diagnoses versus 79.9% obtained by sonography. If, however, we look at the cases in which the pancreas could be screened with both methods the accuracy was almost the same (93.7 CT and 93.3% US). Specificity was almost of the same quality, however, the method of computerized tomography with 0.963 was slightly better than ultrasound with 0.943. As for sensitivity, sonography with 0.838 was better than CT with 0.721. The reason for that is the fact that a big part of the chronic pancreatites (30.3%) were not recognized by means of computerized tomography. (orig.) [de

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

Lifescience Database Archive (English)

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

Lifescience Database Archive (English)

Full Text Available Unc.Pan.20.AllAg.Pancreas mm9 Unclassified Pancreas Pancreas SRX1125784,SRX1125785,...1125798 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Pan.20.AllAg.Pancreas.bed ...

File list: Unc.Pan.50.AllAg.Pancreas [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available Unc.Pan.50.AllAg.Pancreas mm9 Unclassified Pancreas Pancreas SRX1125784,SRX1125785,...1125791 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Pan.50.AllAg.Pancreas.bed ...

Result of radiation therapy for inoperable pancreas cancer

International Nuclear Information System (INIS)

Okawa, Tomohiko; Ikeda, Michio; Tazaki, Eisei; Kaneda, Koichi; Tsuya, Akira.

1978-01-01

Twenty cases of the pancreas cancer were treated by means of 60 Co γ or Linac x-rays during the period between 1958 and 1977 at the Cancer Institute Hospital and Tokyo Women's Medical College. 11 were irradiated by external radiation and 9 by intraoperative radiation. Pancreas irradiation was indicated for relief of pain and alleviation of jaundice although the effect was symptomatic. 2500 rad of intraoperative radiation was reasonable dose in about 10 x 10 cm radiation field. Radical curative irradiation for pancreas cancer might be rarely indicated. Radiotherapy of pancreas cancer should be considered in conjunction with multimodal treatment in the future. (author)

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

Lifescience Database Archive (English)

Full Text Available Unc.Pan.05.AllAg.Pancreas mm9 Unclassified Pancreas Pancreas SRX527836,SRX1125784,S...X527839 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Unc.Pan.05.AllAg.Pancreas.bed ...

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

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

Science.gov (United States)

... 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 ...

Effect of pancreas disease (PD) on quality attributes of raw and smoked fillets of Atlantic salmon (Salmo salar L.)

DEFF Research Database (Denmark)

Lerfall, Jørgen; Larsson, Thomas; Birkeland, Sveinung

2012-01-01

The impact of pancreas disease (PD) on fillet quality of raw and cold-smoked Atlantic salmon was investigated. Commercially reared fish were sorted into six groups: (1) Control (healthy fish), (2) SAV (infection with salmonid alphavirus, without PD outbreak), (3) PD0 (PD diagnosis at slaughter), (4...

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

Lifescience Database Archive (English)

Full Text Available ALL.Pan.50.AllAg.Pancreas mm9 All antigens Pancreas Pancreas SRX111395,ERX651337,SR...ERX383750,SRX672452 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Pan.50.AllAg.Pancreas.bed ...

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

Lifescience Database Archive (English)

Full Text Available ALL.Pan.10.AllAg.Pancreas mm9 All antigens Pancreas Pancreas SRX111395,ERX651337,SR...ERX383754,ERX383752 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Pan.10.AllAg.Pancreas.bed ...

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

Lifescience Database Archive (English)

Full Text Available ALL.Pan.05.AllAg.Pancreas mm9 All antigens Pancreas Pancreas ERX651337,SRX527836,SR...ERX383754,ERX383752 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Pan.05.AllAg.Pancreas.bed ...

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

Lifescience Database Archive (English)

Full Text Available ALL.Pan.20.AllAg.Pancreas mm9 All antigens Pancreas Pancreas SRX111395,ERX651337,SR...ERX383750,SRX672452 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Pan.20.AllAg.Pancreas.bed ...

The value of multislice spiral CT in the pre-operative diagnosis of cleft palate

International Nuclear Information System (INIS)

Tang Guangxi; Sun Lianfen; Zhang Xiaolin; Yu Chengxin; Lu Ji; Wang Xiaopeng; Li Liya; Yang Cheng; Wang Jun; Tian Yiqing

2004-01-01

Objective: To evaluate the practical value of multislice spiral CT (MSCT) in the preoperative diagnosis of cleft palate. Methods: Twenty patients with cleft palate were examined by using thin-slice (1.25 mm/4i) axial MSCT scanning and CT virtual endoscope (CTVE) imaging before and after operations. The cleft of each lesion was measured in the primary axial images. Results: Of the 20 cases, soft-and-hard cleft palate (grade II) was detected in 10 cases, with the clefts of soft palate between 1.5 cm and 2.2 cm, and the clefts of soft-and-hard palate between 1.2 cm and 2.0 cm. The right utter cleft palates were found in 3 cases with the clefts of soft palate between 2.0 cm and 2.5 cm, the clefts of soft-and-hard palate between 2.0 cm and 2.4 cm, and the clefts of hard palate between 1.8 cm and 2.2 cm. The left utter cleft palates (grade III) were found in 5 cases with the clefts of soft palate between 1.2 cm and 1.8 cm, the clefts of soft-and-hard palate between 0.9 cm and 2.0 cm, and the clefts of hard palate between 0.9 cm and 1.8 cm. The bilateral utter cleft palates (grade III) were detected in 2 cases with the clefts of soft palate between 2.1 cm and 2.3 cm, the clefts of soft-and-hard palate between 1.8 cm and 2.0 cm, and the clefts of hard palate between 1.9 cm and 2.3 cm. Conclusion: MSCT could excellently display the shape of all lesions before operation, especially the splitting degree of hard cleft palates in the axial images. Accurate measurements could be done for the cleft of different lesions in MSCT images. CTVE could clearly and directly show the shape of the lesion's interior surface. The pre-operative and post-operative images of each case could be perfectly compared by the combination of MSCT and CTVE

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

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

Lifescience Database Archive (English)

Full Text Available ALL.Pan.05.AllAg.Pancreas hg19 All antigens Pancreas Pancreas SRX347280,SRX134735,S...71,SRX342269,SRX188948,SRX188958 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Pan.05.AllAg.Pancreas.bed ...

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

Lifescience Database Archive (English)

Full Text Available ALL.Pan.20.AllAg.Pancreas hg19 All antigens Pancreas Pancreas SRX136972,ERX103432,S...58,SRX188948,SRX270968,SRX347271 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Pan.20.AllAg.Pancreas.bed ...

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

Lifescience Database Archive (English)

Full Text Available ALL.Pan.10.AllAg.Pancreas hg19 All antigens Pancreas Pancreas SRX136972,SRX136967,S...71,SRX342269,SRX188948,SRX188958 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Pan.10.AllAg.Pancreas.bed ...

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)

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

Lifescience Database Archive (English)

Full Text Available Oth.Pan.05.AllAg.Pancreas mm9 TFs and others Pancreas Pancreas SRX111395,SRX672451,...ERX383750,ERX383751,ERX383754,ERX383752 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Pan.05.AllAg.Pancreas.bed ...

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

Lifescience Database Archive (English)

Full Text Available Oth.Pan.10.AllAg.Pancreas mm9 TFs and others Pancreas Pancreas SRX111395,SRX672451,...ERX383750,ERX383751,ERX383754,ERX383752 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Pan.10.AllAg.Pancreas.bed ...

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

Lifescience Database Archive (English)

Full Text Available Oth.Pan.20.AllAg.Pancreas mm9 TFs and others Pancreas Pancreas SRX111395,SRX672451,...ERX383752,ERX383751,ERX383754,ERX383750 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Pan.20.AllAg.Pancreas.bed ...

File list: Oth.Pan.50.AllAg.Pancreas [Chip-atlas[Archive

Lifescience Database Archive (English)

Full Text Available Oth.Pan.50.AllAg.Pancreas mm9 TFs and others Pancreas Pancreas SRX111395,SRX672451,...ERX383752,ERX383751,ERX383754,ERX383750 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/Oth.Pan.50.AllAg.Pancreas.bed ...

Preoperative intraluminal irradiation of the extrahepatic bile duct tumor

International Nuclear Information System (INIS)

Kamada, Tadashi; Tsujii, Hirohiko; Arimoto, Takuro; Irie, Goro.

1991-01-01

From 1984 through 1986, six patients with extrahepatic bile duct tumor were treated preoperatively with intraluminal irradiation of the bile duct. There were no unresectable cases and pathological examination of the surgical specimens showed moderate to remarkable tumor regression in all cases. Postoperative biliary tract hemorrhage occurred in 2 of 3 patients who received 60 Gy at a point 7.5 mm from the center of the source. With accurate preoperative diagnosis of the tumor extent and careful setting of the target area of intraluminal irradiation, improved local tumor control of extrahepatic bile duct tumor can be expected with this method. (author)

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 ...

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.

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.

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

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.

Computed tomography findings in pancreas divisum

International Nuclear Information System (INIS)

Lindstroem, E.; Ihse, I.

1989-01-01

In 29 patients with abdominal pain the diagnosis of pancreas divisum (PD) was verified by endoscopic retrograde pancreatography (EPR) via both the major and the minor papilla. Computed tomography (CT) was done in all patients to evaluate contour, volume, antero-posterior diameters and attenuation values of the gland in comparison with a normal reference series. Also, the validity of the CT grading of pancreatitis was assessed in comparison with ERP grading. Patients with PD had an increased cranio-caudal diameter of the pancreatic head (p<0.001). Further, the main pancreatic duct was visualized more often in patients with PD (p<0.01), who also had an increasing frequency of pancreatic calcifications (p<0.05). Otherwise there were no differences compared with the normal series. The observed reduction in the volume of the gland in patients with marked pancreatitis at ERP seemingly reflected the severity of inflammation. No cleavage between the dorsal and ventral anlage was identified. CT was found to be too unspecific to be of any use in grading of pancreatitis. In conclusion, CT findings in patients with PD are sparse, unspecific and preferably a reflection of pancreatitis, if present. ERP remains the ''gold standard'' for the diagnosis. (orig.)

Granulomatous Pancreas: A Case Report of Pancreatic Sarcoid

Directory of Open Access Journals (Sweden)

Tatiana Bihun

2017-01-01

Full Text Available Sarcoidosis is a chronic, systemic, noncaseating granulomatous disease process of unknown etiology. Sarcoidosis most commonly manifests in the lungs; however, gastrointestinal manifestations can occur. If in the GI tract, it is almost always found in the liver. Solitary pancreatic lesions are extremely rare, with less than 50 documented cases found in the literature. We present a case of a 61-year-old female, with a past medical history of sarcoidosis, who presented to the ER with unexpected weight loss, scleral icterus, right upper quadrant pain, and epigastric and back pain. US and MRI found a dilated common bile duct and mild dilation of the pancreatic duct, as well as a focal prominence in the head of the pancreas surrounded by areas of atrophy. A pancreaticoduodenectomy procedure was performed and fresh frozen sections were taken. The pathologist made a diagnosis of nonnecrotizing granulomatous pancreatitis. Pancreatic sarcoid is often asymptomatic and a benign finding on autopsy; however, clinicians should be mindful of pancreatic involvement when working up differential diagnosis for pancreatic masses.

Preoperative diagnosis of fallopian tube malignancy with transvaginal color doppler ultrasonography and magnetic resonance imaging after negative hysteroscopy for postmenopausal bleeding.

Science.gov (United States)

Arko, Darja; Žegura, Branka; Virag, Mirjana; Fokter Dovnik, Nina; Takač, Iztok

2014-09-01

Primary fallopian tube carcinoma is a rare malignancy and is not often diagnosed preoperatively. We present a case of a 67-year-old woman who complained of postmenopausal vaginal bleeding. After a negative hysteroscopy, transvaginal ultrasound showed a well vascularized solid-cystic tumor in the adnexal region separate from the ovary. The presence of an adnexal mass was confirmed by MR imaging. Total abdominal hysterectomy with bilateral salpingoophorectomy, omentectomy and appendectomy, as well as pelvic and paraaortic lymphadenectomy was performed. The pathohistological diagnosis was poorly differentiated serous adenocarcinoma of the fallopian tube, FIGO stage IA. The patient was subsequently treated with platinum based adjuvant chemotherapy.

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.

Comparison of preoperative neuroradiographic findings and surgical findings in lumbar disc herniation

International Nuclear Information System (INIS)

Takahara, Kazuhiro; Sera, Keisuke; Nakamura, Masakazu; Uchida, Takeshi; Ito, Nobuyuki.

1997-01-01

Surgical findings in lumbar disc hernia were compared to pre-operative MRI, CTM and myelogram findings. Ninety-one cases were studied using Love's method. The accuracy of hernia diagnosis in MRI was 59.3%, 41.2% in CTM, and 35.2% in myelogram. At the L5/S1 disc level, the accuracy of hernia diagnosis by CTM and myelogram was decreased. MRI was useful for the diagnosis and cure of lumbar disc herniation. (author)

Pancreas Center Data Profile

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... 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...

III Frontier of accurate diagnosis of breast cancer. 1. Present state and prospect of preoperative diagnosis of progression, differential diagnosis of benign and malign natures, and efficacy evaluation of neoadjuvant chemotherapy. 2) Clinical efficacy and problem of FDG-PET (PET/CT) in breast cancer

International Nuclear Information System (INIS)

Kitajima, Kazuhiro; Kaji, Yasushi; Hayashi, Mitsuhiro; Sunagawa, Masakatsu; Murakami, Kouji; Yamazaki, Erena

2008-01-01

On authors' experience and literature, clinical efficacy and limitation of fluorodeoxyglucose-positron emission tomography (FDG-PET) (PET/CT) in the breast cancer are described and discussed for detection of the primary lesion, preoperative staging and lymph node diagnosis, diagnosis of recurrence and remote metastasis, evaluation of therapeutic efficacy, and prediction of prognosis. For routine breast cancer screening, authors think PET/CT is not always effective because of many false positive/negative findings. PET/CT and subsequent CT with iodine contrast media are thought to be useful for preoperative staging and planning in conservative surgery though detection of micro-metastatic nodes are often difficult. PET is reportedly superior to 99m Tc-MDP scintigraphy in bone metastasis detection, but which conceivably depends on the nature (osteogenic/osteolytic) of the lesion. For recurrence and remote metastasis, the diagnostic sensitivity, specificity and accuracy of PET/CT are reported to be as high as 84-98, 84-94 and 86-97%, respectively. Standardization of PET/CT monitoring is now necessary to evaluate the therapeutic efficacy. SUV which indicates the degree of FDG accumulation in the lesion, can be used for prediction of prognosis in future. Awaited is the development of more effective PET/CT apparatus and agent (instead of FDG) for detection of small metastatic lesions, axillary lymphatic metastasis, and viable focus after therapeutic treatments. (R.T.)

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

International Nuclear Information System (INIS)

Stockland, Andrew H.; Willingham, Darrin L.; Paz-Fumagalli, Ricardo; Grewal, Hani P.; McKinney, J. Mark; Hughes, Christopher B.; Walser, Eric M.

2009-01-01

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

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.

EUS – Fine- Needle Aspiration Biopsy (FNAB in the Diagnosis of Pancreatic Adenocarcinoma: A Review

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Kalogeraki Alexandra

2016-03-01

Full Text Available Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS is a relatively new technology that employs endoscopy and high-frequency ultrasound (US. EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach. It has been shown to be a highly sensitive method for the detection of pancreatic masses. It is superior to extracorporeal US and computed tomographic (CT scans, especially when the pancreatic tumor is smaller than 2-3 cm. Although EUS is highly sensitive in detecting pancreatic solid masses, its ability to differentiate between inflammatory masses and malignant disease is limited. Endoscopic retrograde cholangiopancreatography (ERCP brushing, CT-guided biopsies, and transabdominal ultrasound (US have been the standard nonsurgical methods for obtaining a tissue diagnosis of pancreatic lesions, but a substantial false-negative rate has been reported. Transabdominal US-guided fine-needle aspiration biopsy (US-FNAB has been used for tissue diagnosis in patients with suspected pancreatic carcinoma. It has been shown to be highly specific, with no false-positive diagnoses. With the advent of curvilinear echoendoscopes, transgastric and transduodenal EUS-FNAB of the pancreas have become a reality EUS with FNAB has revolutionized the ability to diagnose and stage cancers of the gastrointestinal tract and assess the pancreas. Gastrointestinal cancers can be looked at with EUS and their depth of penetration into the intestinal wall can be determined. Any suspicious appearing lymph nodes can be biopsied using EUS/FNAB. The pancreas is another organ that is well visualized with EUS. Abnormalities

A radiopharmaceutical for pancreatic exocrine functional diagnosis: 62Zn-EDDA metabolism in pancreas.

Science.gov (United States)

Fujibayashi, Y; Saji, H; Kawai, K; Unuma, Y; Miyata, S; Okuno, T; Hosotani, R; Inoue, K; Adachi, H; Horiuchi, K

1986-01-01

The metabolic pathway of radioactive 62Zn-EDDA (ethylenediamine-N,N'-diacetic acid), in the exocrine pancreas was studied with respect to that of endogenous Zn. In pancreatic duct cannulated dog, the secretion of intravenously injected exogenous 62Zn into pancreatic juice increased under the stimulation of CCK-PZ (pancreatic protein secretion stimulating hormone), which closely correlated to endogenous Zn. Moreover, in pancreatic juice, 62Zn as well as endogenous Zn was selectively bound to Zn-metalloenzymes, carboxypeptidase A and B. These results demonstrated the close correlation between the endogenous and the exogenously-administered Zn (62Zn-EDDA), as well as the high availability of 62Zn-EDDA as a marker of pancreatic function for the follow up of carboxypeptidase metabolism.

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 ...

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 ...

Pancreatic neuroendocrine tumor with complete replacement of the pancreas by serous cystic neoplasms in a patient with von Hippel-Lindau disease: a case report.

Science.gov (United States)

Maeda, Shimpei; Motoi, Fuyuhiko; Oana, Shuhei; Ariake, Kyohei; Mizuma, Masamichi; Morikawa, Takanori; Hayashi, Hiroki; Nakagawa, Kei; Kamei, Takashi; Naitoh, Takeshi; Unno, Michiaki

2017-09-25

von Hippel-Lindau disease is a dominantly inherited multi-system syndrome with neoplastic hallmarks. Pancreatic lesions associated with von Hippel-Lindau include serous cystic neoplasms, simple cysts, and neuroendocrine tumors. The combination of pancreatic neuroendocrine tumors and serous cystic neoplasms is relatively rare, and the surgical treatment of these lesions must consider both preservation of pancreatic function and oncological clearance. We report a patient with von Hippel-Lindau disease successfully treated with pancreas-sparing resection of a pancreatic neuroendocrine tumor where the pancreas had been completely replaced by serous cystic neoplasms, in which pancreatic function was preserved. A 39-year-old female with von Hippel-Lindau disease was referred to our institution for treatment of a pancreatic neuroendocrine tumor. Abdominal computed tomography demonstrated a well-enhanced mass, 4 cm in diameter in the tail of the pancreas, and two multilocular tumors with several calcifications, 5 cm in diameter, in the head of the pancreas. There was complete replacement of the pancreas by multiple cystic lesions with diameters ranging from 1 to 3 cm. Magnetic resonance cholangiopancreatography showed innumerable cystic lesions on the whole pancreas and no detectable main pancreatic duct. Endoscopic ultrasound-guided fine-needle aspiration of the mass in the pancreatic tail showed characteristic features of a neuroendocrine tumor. A diagnosis of pancreatic neuroendocrine tumor in the tail of the pancreas and mixed-type serous cystic neoplasms replacing the whole pancreas was made and she underwent distal pancreatectomy while avoiding total pancreatectomy. The stump of the pancreas was sutured as firm as possible using a fish-mouth closure. The patient made a good recovery and was discharged on postoperative day 9. She is currently alive and well with no symptoms of endocrine or exocrine pancreatic insufficiency 8 months after surgery. A pancreas

Pancreatic sarcoidosis discovered during Whipple procedure.

Science.gov (United States)

Cook, Jonathan; Spees, Tanner; Telefus, Phillip; Ranaudo, Jeffrey M; Carryl, Stephen; Xiao, Philip

2013-04-04

Pancreatic sarcoidosis is a rare variant of systemic sarcoidosis, with cases described in literature as recently as January 2010. We present here a case of pancreatic involvement with non-caseating granulomas discovered on laparotomy in a patient with a preoperative diagnosis of pancreatic carcinoma. Computer tomography scan without contrast revealed a well-marginated smooth-shaped tumor in the head of the pancreas morphologically consistent with malignancy. During Whipple procedure, the mass was found to be a large lymph node that contained numerous non-caseating granulomas. Radiologically and clinically, non-caseating granulomas of the pancreas are often misdiagnosed as malignant tumor. Special attention given to this differential diagnosis by surgeons, pathologists and clinicians can avoid misdiagnosis and unnecessary treatment. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2013.

Comparison of preoperative neuroradiographic findings and surgical findings in lumbar disc herniation

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Takahara, Kazuhiro; Sera, Keisuke; Nakamura, Masakazu; Uchida, Takeshi [Nagasaki Mitsubishi Hospital (Japan); Ito, Nobuyuki

1997-09-01

Surgical findings in lumbar disc hernia were compared to pre-operative MRI, CTM and myelogram findings. Ninety-one cases were studied using Love`s method. The accuracy of hernia diagnosis in MRI was 59.3%, 41.2% in CTM, and 35.2% in myelogram. At the L5/S1 disc level, the accuracy of hernia diagnosis by CTM and myelogram was decreased. MRI was useful for the diagnosis and cure of lumbar disc herniation. (author)

Preoperative radiological diagnosis by 99mTc·MIBI-99mTc subtraction scintigraphy for primary hyperparathyroidism

International Nuclear Information System (INIS)

Inouye, Takahiro; Tomita, Toshiki; Shinden, Seiichi; Takagi, Hitoshi; Kano, Shigeru.

1996-01-01

Preoperative radiological diagnosis constitutes the most important factor for the surgical treatment of hyperparathyroidism. In this regard, MRI is useful for detecting the abnormal parathyroid, but it is often difficult to localize it using MRI only. It is thus necessary to combine this procedure with excellent subtraction scintigraphy. We performed both 201 Tl- 99m Tc and 99m Tc·MIBI- 99m Tc subtraction scintigraphy in seven patients with primary hyperparathyroidism and compared them the radiological results. Five patients presented parathyroid adenomas and the rest hypertrophy of the parathyroid. We could detect the abnormal parathyroid in four patients (57.1%) by 201 Tl- 99m Tc subtraction scintigraphy and in six patients (85.7%) by 99m Tc·MIBI- 99m Tc subtraction scintigraphy. We therefore believe that 99m Tc·MIBI- 99m Tc subtraction scintigraphy will become an essential examination for primary hyperparathyroidism rather than the presently employed 201 Tl- 99m Tc subtraction scintigraphy. (author)

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.)

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

GSI Quantitative Parameters: Preoperative Diagnosis of Metastasis Lymph Nodes in Lung Cancer

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Fengfeng YANG

2016-11-01

Full Text Available Background and objective Mediastinal involvement in lung cancer is an important prognostic factor affecting survival, and accurate staging of the mediastinum lymph node correctly identifies patients who can benefit the most from surgery. The aim of this study is to investigate the value of dual-energy spectral computed tomography (DEsCT imaging in differentiating metastatic from non-metastatic lymph nodes in lung cancer. Methods Forty-eight patients with non-small cell lung cancer (NSCLC underwent arterial (AP and portal venous (PP phase contrast-enhanced DEsCT imaging followed by surgical treatment. gemstone spectral imaging (GSI data images were reconstructed and transmitted to an offline workstation. GSI quantitative parameters, including lymph-node size, CT value, IC, water concentration, and spectral curve. Differences were tested for statistical significance using the two-sample t test. ROC analysis was performed to assess diagnostic performance. Results The mean short-axis diameter of metastatic LNs, slope of the spectral Hounsfield unit curve (λHU, normalized iodine concentration measured during, and both AP and PP were significantly higher in metastatic lymph node than that in benign lymph nodes. The best parameter for detecting metastatic lymph nodes was AP λHU when a threshold λHU of 2.75 was used; sensitivity, specificity, and accuracy were 88.2%, 88.4%, and 87.0%, respectively. Conclusion Quantitative assessment with gemstone spectral imaging quantitative parameters showed higher accuracy than the qualitative assessment of conventional CT imaging features for the preoperative diagnosis of metastatic lymph nodes in patients with lung cancer.

Accuracy of preoperative urinary symptoms, urinalysis, computed tomography and cystoscopic findings for the diagnosis of urinary bladder invasion in patients with colorectal cancer.

Science.gov (United States)

Woranisarakul, Varat; Ramart, Patkawat; Phinthusophon, Kittipong; Chotikawanich, Ekkarin; Prapasrivorakul, Siriluck; Lohsiriwat, Varut

2014-01-01

To determine the accuracy of preoperative urinary symptoms, urinalysis, computed tomography (CT) and cystoscopic findings for the diagnosis of urinary bladder invasion in patients with colorectal cancer. Records of patients with colorectal cancer and a suspicion of bladder invasion, who underwent tumor resection with partial or total cystectomy between 2002 and 2013 at the Faculty of Medicine Siriraj Hospital, were reviewed. Correlations between preoperative urinary symptoms, urinalysis, cystoscopic finding, CT imaging and final pathological reports were analyzed. This study included 90 eligible cases (71% male). The most common site of primary colorectal cancer was the sigmoid colon (44%), followed by the rectum (33%). Final pathological reports showed definite bladder invasion in 53 cases (59%). Significant features for predicting definite tumor invasion were gross hematuria (OR 13.6, sensitivity 39%, specificity 73%), and visible tumor during cystoscopy (OR 5.33, sensitivity 50%, specificity 84%). Predictive signs in CT imaging were gross tumor invasion (OR 7.07, sensitivity 89%, specificity 46%), abnormal enhancing mass at bladder wall (OR 4.09, sensitivity 68%, specificity 66%), irregular bladder mucosa (OR 3.53, sensitivity 70%, specificity 60% ), and loss of perivesical fat plane (OR 3.17, sensitivity 81%, specificity 43%). However, urinary analysis and other urinary tract symptoms were poor predictors of bladder involvement. The present study demonstrated that the most relevant preoperative predictors of definite bladder invasion in patients with colorectal cancer are gross hematuria, a visible tumor during cystoscopy, and abnormal CT findings.

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...

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...

Cardiac risk stratification with myocardial perfusion imaging in potential renal-pancreas transplant recipients

International Nuclear Information System (INIS)

McCarthy, M.C.; Larcos, G.; Chapman, J.

1998-01-01

Full text: Combined renal/pancreas transplantation is used in patients with severe type-1 diabetes and renal failure. Many patients have asymptomatic coronary artery disease (CAD). Thus, myocardial perfusion imaging (MPI) is widely used for preoperative risk assessment, however, its value has recently been challenged. The purpose of this study was to determine the predictive value of MPI compared to coronary angiography and/or thirty day perioperative cardiac events (cardiac death, myocardial infarction and unstable angina). We reviewed the MPI in 132 patients that were referred for possible renal pancreas transplantation during the period between 1987 - June 1997. Fifty five patients were excluded because of: still awaiting transplantation (n=19) ongoing medical assessment (n=21), received kidney only transplant (n=6) or other factors (n=9). Thus, 77 patients form the basis of this report. Seventy one patients were transplanted, 5 had coronary angiography and one died before transplantation but with coronary anatomy defined at autopsy. All patients (39 male, 38 female; mean age 37 years) had Tl-201 or Tc-99m MIBI SPECT at Westmead (n=54) or elsewhere (n=23). Patients underwent MPI, a mean of 12.1 months before transplantation and a mean of 6 months before coronary angiography or autopsy. MPI was normal in 64 (83%) and abnormal in 13 (17%) patients. Of the abnormal MPI, 7 patients had CAD and one had unstable angina post-operatively (PPV = 8/13; 61%). One patient had a fixed defect post CABG but proceeded to transplant with-out event; the other 4 patients had normal coronary anatomy. Of the normal MPIs there were no transplant related cardiac events, but one patient required CABG >12 months post MPI and a further patient died >12 months post transplant and was shown to have CAD at autopsy (NPV=62/64;97%). In conclusion we have found an excellent NPV and an acceptable PPV for MPI in potential renal pancreas graft recipients

Cardiac risk stratification with myocardial perfusion imaging in potential renal-pancreas transplant recipients

Energy Technology Data Exchange (ETDEWEB)

McCarthy, M.C.; Larcos, G.; Chapman, J. [Westmead Hospital, Westmead, Sydney, NSW (Australia). Departments of Nuclear Medicine and Ultrasound

1998-06-01

Full text: Combined renal/pancreas transplantation is used in patients with severe type-1 diabetes and renal failure. Many patients have asymptomatic coronary artery disease (CAD). Thus, myocardial perfusion imaging (MPI) is widely used for preoperative risk assessment, however, its value has recently been challenged. The purpose of this study was to determine the predictive value of MPI compared to coronary angiography and/or thirty day perioperative cardiac events (cardiac death, myocardial infarction and unstable angina). We reviewed the MPI in 132 patients that were referred for possible renal pancreas transplantation during the period between 1987 - June 1997. Fifty five patients were excluded because of: still awaiting transplantation (n=19) ongoing medical assessment (n=21), received kidney only transplant (n=6) or other factors (n=9). Thus, 77 patients form the basis of this report. Seventy one patients were transplanted, 5 had coronary angiography and one died before transplantation but with coronary anatomy defined at autopsy. All patients (39 male, 38 female; mean age 37 years) had Tl-201 or Tc-99m MIBI SPECT at Westmead (n=54) or elsewhere (n=23). Patients underwent MPI, a mean of 12.1 months before transplantation and a mean of 6 months before coronary angiography or autopsy. MPI was normal in 64 (83%) and abnormal in 13 (17%) patients. Of the abnormal MPI, 7 patients had CAD and one had unstable angina post-operatively (PPV = 8/13; 61%). One patient had a fixed defect post CABG but proceeded to transplant with-out event; the other 4 patients had normal coronary anatomy. Of the normal MPIs there were no transplant related cardiac events, but one patient required CABG >12 months post MPI and a further patient died >12 months post transplant and was shown to have CAD at autopsy (NPV=62/64;97%). In conclusion we have found an excellent NPV and an acceptable PPV for MPI in potential renal pancreas graft recipients

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...

Mucinous cystic neoplasm of the pancreas in a male patient

Directory of Open Access Journals (Sweden)

Kazuhiro Yoshida

2011-04-01

Full Text Available Mucinous cystic neoplasms (MCNs make up a morphologic family of similar appearing tumors arising in the ovary and various extraovarian organs such as pancreas, hepatobiliary tract and mesentery. MCNs of the pancreas　occur almost exclusively in women. Here, we report a rare case of MCN in a male patient. A 39-year-old man was admitted to our hospital with the chief complaint of back pain. Abdominal computed tomography revealed a multilocular cyctic mass 6.3 cm in diameter in the pancreatic tail. In addition, the outer wall and septae with calcification were demonstrated in the cystic lesion. On magnetic resonance imaging , the cystic fluid had low intensity on T1-weighted imaging and high intensity on T2-weighted imaging. Endoscopic retrograde cholangio-pancreatography (ERCP showed neither communication between the cystic lesion and the main pancreatic duct nor encasement of the main pancreatic duct. Endoscopic ultrasonography revealed neither solid component nor thickness of the septae in the cystic lesion. Consequently, we performed distal pancreatectomy with splenectomy under the diagnosis of cystic neoplasia of the pancreas. Histopathologically, the cystic lesion showed two distinct component: an inner epithelial layer and an outer densely cellular ovarian-type stromal layer. Based on these findings, the cystic lesion was diagnosed as MCN.

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.

Clinical target volume delineation including elective nodal irradiation in preoperative and definitive radiotherapy of pancreatic cancer

Directory of Open Access Journals (Sweden)

Caravatta Luciana

2012-06-01

Full Text Available Abstract Background Radiotherapy (RT is widely used in the treatment of pancreatic cancer. Currently, recommendation has been given for the delineation of the clinical target volume (CTV in adjuvant RT. Based on recently reviewed pathologic data, the aim of this study is to propose criteria for the CTV definition and delineation including elective nodal irradiation (ENI in the preoperative and definitive treatment of pancreatic cancer. Methods The anatomical structures of interest, as well as the abdominal vasculature were identified on intravenous contrast-enhanced CT scans of two different patients with pancreatic cancer of the head and the body. To delineate the lymph node area, a margin of 10 mm was added to the arteries. Results We proposed a set of guidelines for elective treatment of high-risk nodal areas and CTV delineation. Reference CT images were provided. Conclusions The proposed guidelines could be used for preoperative or definitive RT for carcinoma of the head and body of the pancreas. Further clinical investigations are needed to validate the defined CTVs.

Diagnosis and treatment of ampullary tumors

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YIN Tao

2017-02-01

Full Text Available Ampullary tumors mainly manifest as obstructive jaundice and ampullary mass in clinical practice and are difficult to be identified in early stage due to a complex structure of the anatomical site, a deep location, and hidden symptoms. Sometimes a qualitative diagnosis cannot be made. Based on the experience in the treatment of ampullary tumors for many years in our center, this article summarizes the features of ampullary tumors from the aspects of clinical manifestations, diagnosis, treatment, and prognosis, especially the issues regarding imaging evaluation of ampullary tumors, selection of surgical procedure, and prognosis. An early diagnosis is the key to the treatment of ampullary tumors, and early identification and treatment of lesions have great impacts on patients′ prognosis. Accurate preoperative imaging evaluation, a professional diagnosis and treatment team, accurate preoperative and intraoperative pathological analysis, and implementation of reasonable therapeutic strategy are the key to patients′ recovery.

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...

Ultrasound and MR-imaging in preoperative evaluation of two rare cases of scar endometriosis

OpenAIRE

Pados, George; Tympanidis, John; Zafrakas, Menelaos; Athanatos, Dimitrios; Bontis, John N

2008-01-01

Scar or incisional endometriosis is a rare, often misdiagnosed, pathologic condition of the abdominal wall. Two cases of incisional endometriosis are presented. Both patients presented with atypical cyclic pain and palpable nodules on scars of previous cesarean sections. In both cases, the mass was totally excised, after accurate preoperative evaluation with 2-D ultrasound, power Doppler and MRI. Microscopic examination confirmed the preoperatively presumed diagnosis of cutaneous endometriosi...

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

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...

Endocrine pancreas development at weaning in goat kids

Directory of Open Access Journals (Sweden)

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.

Inflammatory myofibroblastic tumor in the head of the pancreas with anorexia and vomiting in a 69-year-old man: A case report.

Science.gov (United States)

Ding, Ding; Bu, Xianmin; Tian, Feng

2016-08-01

Inflammatory myofibroblastic tumor (IMT) is a rare condition of unclear etiology that is commonly observed in the lung but rarely in the pancreas. WHO classified IMT as a potentially malignant or aggressive tumor. In the present report, the case of a 69-year-old male patient with an IMT in the head of the pancreas, who experienced anorexia, nausea and vomiting, is presented. The patient's clinical symptoms were nonspecific, and the imaging findings revealed a hypovascularized pancreatic mass with stenosis of the descending duodenum. The electronic endoscopy findings revealed protruding lesions in the duodenal bulb and the descending duodenum. Biopsies of the mass were conducted with an electronic endoscope, but were not diagnostic. Subsequent duodenopancreatectomy aided in determining a pathological diagnosis of IMT, based on the histology and immunohistochemistry results. The patient experienced a recovery without further incident, as observed during a regular follow-up 3 years later. IMT in the head of the pancreas is rare, particularly in adults. In the present study, an extremely rare case of IMT involving the head of the pancreas in an adult patient is presented, and the therapeutic options for this condition are discussed.

Agreement between pre-operative and intra-operative bacteriological samples in 85 chronic peri-prosthetic infections.

Science.gov (United States)

Matter-Parrat, V; Ronde-Oustau, C; Boéri, C; Gaudias, J; Jenny, J-Y

2017-04-01

Whether pre-operative microbiological sampling contributes to the management of chronic peri-prosthetic infection remains controversial. We assessed agreement between the results of pre-operative and intra-operative samples in patients undergoing single-stage prosthesis exchange to treat chronic peri-prosthetic infection. Agreement between pre-operative and intra-operative samples exceeds 75% in patients undergoing single-stage exchange of a hip or knee prosthesis to treat chronic peri-prosthetic infection. This single-centre retrospective study included 85 single-stage prosthesis exchange procedures in 82 patients with chronic peri-prosthetic infection at the hip or knee. Agreement between pre-operative and intra-operative sample results was evaluated. Changes to the initial antibiotic regimen made based on the intra-operative sample results were recorded. Of 149 pre-operative samples, 109 yielded positive cultures, in 75/85 cases. Of 452 intra-operative samples, 354 yielded positive cultures, in 85/85 cases. Agreement was complete in 54 (63%) cases and partial in 9 (11%) cases; there was no agreement in the remaining 22 (26%) cases. The complete agreement rate was significantly lower than 75% (P=0.01). The initial antibiotic regimen was inadequate in a single case. Pre-operative sampling may contribute to the diagnosis of peri-prosthetic infection but is neither necessary nor sufficient to confirm the diagnosis and identify the causative agent. The spectrum of the initial antibiotic regimen cannot be safely narrowed based on the pre-operative sample results. We suggest the routine prescription of a probabilistic broad-spectrum antibiotic regimen immediately after the prosthesis exchange, even when a pathogen was identified before surgery. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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.

Benign Tumors of the Pancreas-Radical Surgery Versus Parenchyma-Sparing Local Resection-the Challenge Facing Surgeons.

Science.gov (United States)

Beger, Hans G

2018-03-01

Pancreaticoduodenectomy and left-sided pancreatectomy are the surgical treatment standards for tumors of the pancreas. Surgeons, who are requested to treat patients with benign tumors, using standard oncological resections, face the challenge of sacrificing pancreatic and extra-pancreatic tissue. Tumor enucleation, pancreatic middle segment resection and local, duodenum-preserving pancreatic head resections are surgical procedures increasingly used as alternative treatment modalities compared to classical pancreatic resections. Use of local resection procedures for cystic neoplasms and neuro-endocrine tumors of the pancreas (panNETs) is associated with an improvement of procedure-related morbidity, when compared to classical Whipple OP (PD) and left-sided pancreatectomy (LP). The procedure-related advantages are a 90-day mortality below 1% and a low level of POPF B+C rates. Most importantly, the long-term benefits of the use of local surgical procedures are the preservation of the endocrine and exocrine pancreatic functions. PD performed for benign tumors on preoperative normo-glycemic patients is followed by the postoperative development of new onset of diabetes mellitus (NODM) in 4 to 24% of patients, measured by fasting blood glucose and/or oral/intravenous glucose tolerance test, according to the criteria of the international consensus guidelines. Persistence of new diabetes mellitus during the long-term follow-up after PD for benign tumors is observed in 14.5% of cases and after surgery for malignant tumors in 15.5%. Pancreatic exocrine insufficiency after PD is found in the long-term follow-up for benign tumors in 25% and for malignant tumors in 49%. Following LP, 14-31% of patients experience postoperatively NODM; many of the patients subsequently change to insulin-dependent diabetes mellitus (IDDM). The decision-making for cystic neoplasms and panNETs of the pancreas should be guided by the low surgical risk and the preservation of pancreatic metabolic

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

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...

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.

Pre-operative diagnosis of thyroid cancer: Clinical, radiological and ...

African Journals Online (AJOL)

The diagnosis or exclusion of cancer in the thyroid nodule remains a clinical dilemma for general surgeons and endocrinologists. Nodular disease of the thyroid is very common, while cancer is rare; a definite diagnosis of either is difficult to make. The general prevalence of thyroid nodules is very high. They are detectable ...

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

Diagnosis and prognosis of primary breast cancer

International Nuclear Information System (INIS)

Robertson, J. F. R.; Evans, A. J.

1997-01-01

The diagnosis of breast cancer should be made in the context of a multidisciplinary team: preoperative diagnosis can be made in over 90 % of patients with symptomatic and screen-detected cancers. A preoperative diagnosis allows patients the opportunity to come to terms with the diagnosis of breast cancer and to consider their treatment options before progressing to therapeutic surgery. Surgery remains the primary therapeutic treatment for operable breast cancer with radiotherapy and systemic therapies as adjuvant treatments. Surgery in addition provides pathological specimens from which important prognostic information may be obtained. The traditional TNM classification in itself is no longer sufficient although there is still c considerable prognostic information to be gained in staging patients. Markers of tumour biology provide prognostic data independent of TNM staging. Both need to be considered in any overall assessment of patient prognosis

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...

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.)

Diagnosis of acute appendicitis: Current criteria

International Nuclear Information System (INIS)

Rodriguez Fernandez, Zenen

2009-01-01

INTRODUCTION: The aim of present paper was to identify some features related to preoperative diagnosis of acute appendicitis, according the selected variables, as well as to establish comparisons with findings from other authors. METHODS: We made a prospective, descriptive and observational study of 560 patients operated on and discharged with the histopathology diagnosis of acute appendicitis. Patients were seen in General Surgery Service of the 'Saturnino Lora' Teaching Provincial Hospital of Santiago de Cuba during year 2006. RESULTS: Among the more significant results were the predominance of young males with a mean age of 25,2 years, and the preponderance of the clinical diagnosis. Mean time of preoperative course was greater in men, and there was a predominance of gangrenous and perforated varieties, although the primacy was for the suppurative appendicitis. In the deceased ones the more severe pathologic histology ways were detected, and these were elderlies presenting with atypical clinical manifestations of disease. CONCLUSIONS: Clinical method has nowadays is of capital significance, since thorough it is possible early to diagnose this so common urgency, and to reduce the preoperative course time, whose length is cause of a unnecessary morbidity and mortality. (author)

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.

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

Directory of Open Access Journals (Sweden)

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.

Dynamic computed tomography of the pancreas in normal dogs and in a dog with pancreatic insulinoma.

Science.gov (United States)

Iseri, Toshie; Yamada, Kazutaka; Chijiwa, Kousaku; Nishimura, Ryohei; Matsunaga, Satoru; Fujiwara, Reina; Sasaki, Nobuo

2007-01-01

To establish optimal imaging conditions for enhanced computed tomography (CT) for canine pancreatic tumors, 10 healthy beagles were subjected to dynamic CT. This technique was then applied to a dog with suspected insulinoma. The changes in mean peak enhancement and the delay time of the aorta and pancreas were determined. In normal beagles, maximal arterial and pancreatic CT enhancement was observed at 15 +/- 2 s (795 +/- 52 Housfield unit [HU]) and 28 +/- 9 s (118 +/- 16HU) after contrast medium injection, respectively. Multiphase enhanced CT was performed in a pug with suspected insulinoma using the CT protocol defined for the normal beagles with some parameters modified; the images were acquired at the arterial (14 s after contrast medium injection), pancreatic (after 28 s), and equilibrium (after 90 s) phases; scanning was followed by exploratory laparotomy. CT images were characterized by an enhanced mass in the left pancreatic lobe at the arterial phase, during which the difference between the CT values of the mass and normal pancreas was the highest. Histopathologic diagnosis of the pancreatic mass was insulinoma. Thus, it appears that enhanced CT imaging can be used to delineate the pancreas from a pancreatic mass, and it may be helpful in deciding the need for surgery.

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.

Intraoperative radiotherapy for cancer of the pancreas

International Nuclear Information System (INIS)

Manabe, Tadao; Nagai, Toshihiro; Tobe, Takayoshi; Shibamoto, Yuta; Takahashi, Masaharu; Abe, Mitsuyuki

1985-01-01

Seven patients treated by intraoperative radiotherapy for cancer of the pancreas were evaluated. Three patients undergoing pancreaticoduodenectomy for cancer of the head of the pancreas received a dose of 2,500--3,000 rad (6--10 MeV Betatron) intraoperatively with or without external beam irradiation at a dose of 2,520 rad (10 MeV lineac X-ray). One patient developed radiation pancreatitis and died 0.8 month after surgery. Autopsy revealed the degeneration of cancer cells in the involved superior mesenteric artery. One died of hepatic metastasis 8.5 months after surgery, however, recurrence was not found in the irradiation field. The other patient who had external beam irradiation combined with intraoperative radiotherapy is alive 7.5 months after surgery. Four patients with unresectable cancer of the body of the pancreas received a dose of 2,500--3,000 rad (13--18 MeV Betatron) intraoperatively with or without external beam irradiation at a dose of 1,500--5,520 rad (10 MeV lineac X-ray). One patient died of peritonitis carcinomatosa 3.0 months after surgery. One patient died of DIC 0.6 month after surgery. Two patients are alive 1.0 and 6.5 months after surgery. In these patients with intraoperative radiotherapy for unresectable cancer of the pancreas, remarkable effects on relief of pain and shrinkage of tumor were obtained. Further pursuit of intraoperative and external beam radiotherapies in combination with pancreatectomy should be indicated in an attempt to prolong survival of patient with cancer of the pancreas. (author)

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

An interesting case of isolated pancreatic teratoma: lessons to learn.

Science.gov (United States)

Razman, J; Azlanudin, A; Eyad, A J; Zahiah, M; Das, S

2012-11-01

Mature cystic teratomas of the pancreas are extremely rare tumours encountered in day-to-day clinical practice. Only few cases have been reported to date involving all age groups. The management, diagnosis and evaluation of this tumor are questionable, with definitive diagnosis taking place intra-operatively. We hereby report the case in a 30 year-old-male who presented with newly diagnosed diabetes mellitus and during the follow up he was noted to have elevated liver enzymes clinically, he was asymptomatic. The computerized tomography revealed a retropancreatic mass and pushing the mesenteric veins anteriorly. The mass was hypodense in nature and there was presence of calcification. Although the patient was asymptomatic, the decision for resecting the mass was made in view of the size and possibility of malignancy. In conclusion, considering the size and approximity of the mass to the pancreas, Whipple procedure's is the most appropriate approach although the histological diagnosis has not been established preoperatively.

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.

Comparison of Scintigraphic and Radiological Results in the Diagnosis of Pancreatic Diseases

Energy Technology Data Exchange (ETDEWEB)

Deininger, H. K.; Sielaff, H. J. [Strahlenklinik der Staedt. Krankenanstalten Heilbronn, Heilbronn, Federal Republic of Germany (Germany)

1969-05-15

The results obtained by pancreas scanning and standard radiological diagnostic methods are compared. The roentgenographic examinations of the stomach, intestine, colon, biliary tract and kidneys were performed by standard X-ray methods and by abdominal tomography with pneumoretroperitoneum. Special methods of a radiological pancreatic diagnosis, e.g. selective angiography and intra-operative pancreatography, are intentionally not considered. So far 192 pancreas scans have been carried out after administration of {sup 75}Se-1 -selenomethionine. The patients were prepared either with a special diet or a fasting period. The quality of the pancreas scans depended on the functional state of the pancreatic tissue and a comparison with phantom studies allowed an approximate estimation of the extent of the parenchymatous lesions. Of the 87 cases with proven pancreatic diseases the results were compared with the scintigraphical and radiological findings. This comparative research illustrates the superiority of pancreas scanning over the conventional rontgenographic methods in the exclusion or detection of pancreatic diseases. (author)

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

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

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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 ...

Preoperative depression symptom severity and its impact on adherence to preoperative beta-blocker therapy.

Science.gov (United States)

Schonberger, Robert B; Feinleib, Jessica; Holt, Natalie; Dai, Feng; Brandt, Cynthia; Burg, Matthew M

2014-12-01

To test the association among depression symptoms, distressed personality type, and preoperative beta-blocker nonadherence and to estimate the prevalence of untreated major depression in this population. Prospective observational study. A veterans hospital. One hundred twenty patients on outpatient beta-blocker therapy presenting for surgery. The Patient Health Questionnaire (PHQ)-9, the D-Scale-14 (DS14), and Modified Morisky Scale (MMS) questionnaires. Of 99 participants who presented for surgery, the incidence of preoperative nonadherence was 14.1% (95% confidence interval 7%-21%), consistent with prior research. Nonadherence was 9.5% among those with no depression, 27.8% among those with mild depression, and 28.6% among those with moderate-to-severe depression (Cochran-Armitage test for trend p = 0.03). Distressed personality type was found in 35% of the cohort (95% confidence interval 26-45%) and was not associated with beta-blocker nonadherence (Fisher's exact test, p = 0.24). Among participants with symptoms of major depressive disorder (n = 25, 25.3%), more than half (n = 14, 56%) had no indication of depression listed at their most recent primary care visit. Patients with symptoms of depression on chronic beta-blocker therapy are susceptible to medication nonadherence on the day of surgery. Most surgical patients with symptoms of major depression lack a diagnosis of depression. Preoperative depression screening may thus (1) identify a population at increased risk of beta-blocker withdrawal, and (2) identify patients who may benefit from anesthesiologist-initiated referral for this treatable condition. Copyright © 2014 Elsevier Inc. All rights reserved.

Cochlin-tomoprotein (CTP) detection test identified perilymph leakage preoperatively in revision stapes surgery.

Science.gov (United States)

Kataoka, Yuko; Ikezono, Tetsuo; Fukushima, Kunihiro; Yuen, Koji; Maeda, Yukihide; Sugaya, Akiko; Nishizaki, Kazunori

2013-08-01

Perilymphatic fistula (PLF) is defined as an abnormal leakage between perilymph from the labyrinth to the middle ear. Symptoms include hearing loss, tinnitus, and vertigo. The standard mode of PLF detection is intraoperative visualization of perilymph leakage and fistula, which ostensibly confirms the existence of PLF. Other possible methods of diagnosis include confirmation of pneumolabyrinth via diagnostic imaging. Recently, a cochlin-tomoprotein (CTP) detection test has been developed that allows definitive diagnosis of PLF-related hearing loss. We report the case of a 45-year-old man who presented with right-sided tinnitus, hearing loss, and dizziness 30 years after stapes surgery. Middle ear lavage was performed after myringotomy. A preoperative diagnosis of PLF was reached using the CTP detection test. Intraoperative observations included a necrotic long process of the incus, displaced wire piston, and fibrous tissue in the oval window. Perilymph leakage was not evident. The oval window was closed with fascia, and vertigo disappeared within 2 weeks postoperatively. When PLF is suspected after stapes surgery, the CTP detection test can be a useful, highly sensitive, and less invasive method for preoperative diagnosis. Copyright © 2012 Elsevier Ireland Ltd. 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)

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

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.

IgG4-related disease: with emphasis on the biopsy diagnosis of autoimmune pancreatitis and sclerosing cholangitis.

Science.gov (United States)

Detlefsen, Sönke; Klöppel, Günter

2018-04-01

In 2011, chronic fibroinflammatory processes occurring simultaneously or metachronously in various organs and associated with elevated IgG4 serum levels and/or tissue infiltration with IgG4-positive plasma cells have been recognized as manifestations of a systemic disorder called IgG4-related disease (IgG4-RD). The histologic key findings are lymphoplasmacytic infiltration rich in IgG4-positive plasma cells combined with storiform fibrosis and obliterative phlebitis. Among the organs mainly affected by IgG4-RD are the pancreas and the extrahepatic bile ducts. The pancreatic and biliary alterations have been described under the terms autoimmune pancreatitis (AIP) and sclerosing cholangitis, respectively. These diseases are currently more precisely called IgG4-related pancreatitis (or type 1 AIP to distinguish it from type 2 AIP that is unrelated to IgG4-RD) and IgG4-related sclerosing cholangitis (IgG4-related SC). Clinically and grossly, both diseases commonly imitate pancreatic and biliary adenocarcinoma, tumors that are well known for their dismal prognosis. As IgG4-RD responds to steroid treatment, making a resection of a suspected tumor unnecessary, a biopsy is often required to establish the preoperative diagnosis. This review discusses the morphologic spectrum of IgG4-related pancreatitis and IgG4-related SC and focuses on the biopsy relevant histologic features for the diagnosis and differential diagnosis of these diseases.

Carcinoma of the pancreas head in a woman, surviving 13 years after radiotherapy of a blastoma lymphoreticularis of the stomach

Energy Technology Data Exchange (ETDEWEB)

Kharbov, I; Velichkov, L; Angelova, V; Velev, G [Meditsinska Akademiya, Sofia (Bulgaria). Katedra po Rentgenologiya i Radiologiya

1974-01-01

Combination of two neoplastic processes with different morphological characteristics in patients is rarely observed. A case of blastoma lymphoreticularis with abdominal localization, liver, spleen, abdominal lymph nodes and predominantly the stomach, is reported. The diagnosis is verified by histological examination after laparotomia. Radiotherapy (telecobalto therapy and deep roentgen therapy) is carried out from 1960 to 1968. At dissection (1972) a total destruction of the blastoma and the development of a carcinoma of the pancreas head are found. As a result from the radiotherapy a summary dose of 1750 rads for 8 years in the pancreas area is realized. This is of the range of the optimal blastomogenic dose, which, together with the time of the carcinoma development, support the supposition for the radioinduction of the carcinoma. (INIS)

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...

[Design of a preoperative predictive score for choledocholithiasis].

Science.gov (United States)

Bueno Lledó, Jose; Ibáñez Cirión, Jose Luis; Torregrosa Gallud, Antonio; López Andújar, Rafael

2014-11-01

Choledocholithiasis is the most common cause of obstructive jaundice and occurs in 5-10% of patients with cholelithiasis. To design a preoperative predictive score for choledocholithiasis. A prospective study was carried out in 556 patients admitted to our department for biliary disease. Preoperative clinical, laboratory, and ultrasound variables were compared between patients without choledocholithiasis and 65 patients with this diagnosis. A multivariate logistic analysis was performed to obtain a predictive model of choledocholithiasis, determining sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Predictors of choledocholithiasis were the presence of a prior history of biliary disease (history of biliary colic, acute cholecystitis, choledocholithiasis or acute biliary pancreatitis) (p=0.021, OR=2.225, 95% CI: 1.130-4.381), total bilirubin values >4mg/dl (p=0.046, OR=2.403, 95% CI: 1.106-5.685), alkaline phosphatase values >150mg/dl (p=0.022 income, OR=2.631, 95%: 1.386-6.231), gamma-glutamyltransferase (GGT) values >100mg/dl (p=0.035, OR=2.10, 95% CI: 1.345-5.850), and an ultrasound finding of biliary duct >8mm (p=0.034, OR=3.063 95% CI: 1086-8649). A score superior to 5 had a specificity and PPV of 100% for detecting choledocholithiasis and a score less than 3 had a sensitivity and NPV of 100% for excluding this diagnosis. The preoperative score can exclude or confirm the presence of choledocholithiasis and allows patients to directly benefit from laparoscopic cholecystectomy (LC) or prior endoscopic retrograde cholangiopancreatography (ERCP). Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

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...

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

International Nuclear Information System (INIS)

Yamada, Shigeru; Ando, Koichi

2003-01-01

The purpose of this study is to investigate the combination of chemotherapy and heavy-ion particle therapy for pancreas cancer. We measured surviving fractions in four culture pancreas 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. (author)

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

International Nuclear Information System (INIS)

Yamada, Shigeru; Ando, Koichi

2004-01-01

The purpose of this study is to investigate the combination of chemotherapy and heavy-ion particle therapy for pancreas cancer. We measured surviving fractions in four culture pancreas 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. (author)

Preoperative Prediction of Ki-67 Labeling Index By Three-dimensional CT Image Parameters for Differential Diagnosis Of Ground-Glass Opacity (GGO.

Directory of Open Access Journals (Sweden)

Mingzheng Peng

Full Text Available The aim of this study was to predict Ki-67 labeling index (LI preoperatively by three-dimensional (3D CT image parameters for pathologic assessment of GGO nodules. Diameter, total volume (TV, the maximum CT number (MAX, average CT number (AVG and standard deviation of CT number within the whole GGO nodule (STD were measured by 3D CT workstation. By detection of immunohistochemistry and Image Software Pro Plus 6.0, different Ki-67 LI were measured and statistically analyzed among preinvasive adenocarcinoma (PIA, minimally invasive adenocarcinoma (MIA and invasive adenocarcinoma (IAC. Receiver operating characteristic (ROC curve, Spearman correlation analysis and multiple linear regression analysis with cross-validation were performed to further research a quantitative correlation between Ki-67 labeling index and radiological parameters. Diameter, TV, MAX, AVG and STD increased along with PIA, MIA and IAC significantly and consecutively. In the multiple linear regression model by a stepwise way, we obtained an equation: prediction of Ki-67 LI=0.022*STD+0.001* TV+2.137 (R=0.595, R's square=0.354, p<0.001, which can predict Ki-67 LI as a proliferative marker preoperatively. Diameter, TV, MAX, AVG and STD could discriminate pathologic categories of GGO nodules significantly. Ki-67 LI of early lung adenocarcinoma presenting GGO can be predicted by radiologic parameters based on 3D CT for differential diagnosis.

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

Multidetector-row computed tomography in the preoperative diagnosis of intestinal complications caused by clinically unsuspected ingested dietary foreign bodies: a case series emphasizing the use of volume rendering techniques

Energy Technology Data Exchange (ETDEWEB)

Teixeira, Augusto Cesar Vieira; Torres, Ulysses dos Santos; Oliveira, Eduardo Portela de; Gual, Fabiana; Bauab Junior, Tufik, E-mail: usantor@yahoo.com.br [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Hospital de Base. Serv. de Radiologia e Diagnostico por Imagem; Westin, Carlos Eduardo Garcia [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Hospital de Base. Cirurgia Geral; Cardoso, Luciana Vargas [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Hospital de Base. Setor de Tomografia Computadorizada

2013-11-15

Objective: the present study was aimed at describing a case series where a preoperative diagnosis of intestinal complications secondary to accidentally ingested dietary foreign bodies was made by multidetector-row computed tomography (MDCT), with emphasis on complementary findings yielded by volume rendering techniques (VRT) and curved multiplanar reconstructions (MPR). Materials and Methods: The authors retrospectively assessed five patients with surgically confirmed intestinal complications (perforation and/or obstruction) secondary to unsuspected ingested dietary foreign bodies, consecutively assisted in their institution between 2010 and 2012. Demographic, clinical, laboratory and radiological data were analyzed. VRT and curved MPR were subsequently performed. Results: preoperative diagnosis of intestinal complications was originally performed in all cases. In one case the presence of a foreign body was not initially identified as the causal factor, and the use of complementary techniques facilitated its retrospective identification. In all cases these tools allowed a better depiction of the entire foreign bodies on a single image section, contributing to the assessment of their morphology. Conclusion: although the use of complementary techniques has not had a direct impact on diagnostic performance in most cases of this series, they may provide a better depiction of foreign bodies' morphology on a single image section. (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

The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas

International Nuclear Information System (INIS)

Krestan, C.; Czerny, C.; Gstoettner, W.; Franz, P.

2003-01-01

The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT depicted bony erosions caused by recurrent cholesteatoma, bony defects of the facial nerve and of the labyrinth, and a defect of the tegmen tympani with a soft tissue mass in the middle ear. Postoperative MRI delineated neuritis of the facial nerve, labyrinthitis, and a meningo-encephalocele protruding into the middle ear. HRCT and MRI are excellent imaging tools to depict either bony or soft tissue complications or both if caused by acquired cholesteatomas. According to our findings and to the literature HRCT and MRI are complementary imaging methods to depict pre- or postoperative complications of acquired cholesteatomas if these are suspected by clinical examination. (orig.) [de

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 ...

Pancreas as Delayed Site of Metastasis from Papillary Thyroid Carcinoma

Directory of Open Access Journals (Sweden)

Mutahir A. Tunio

2013-01-01

Full Text Available Introduction. Follicular variant (FV papillary thyroid carcinoma (PTC has aggressive biologic behavior as compared to classic variant (CV of PTC and frequently metastasizes to the lungs and bones. However, metastasis to the pancreas is extremely rare manifestation of FV-PTC. To date, only 9 cases of PTC have been reported in the literature. Pancreatic metastases from PTC usually remain asymptomatic or manifest as repeated abdominal aches. Associated obstructive jaundice is rare. Prognosis is variable with reported median survival from 16 to 46 months. Case Presentation. Herein we present a 67-year-old Saudi woman, who developed pancreatic metastases seven years after total thyroidectomy and neck dissection followed by radioactive iodine ablation (RAI for FV-PTC. Metastasectomy was performed by pancreaticoduodenectomy followed by sorafenib as genetic testing revealed a BRAF V600E mutation. She survived 32 months after the pancreatic metastasis diagnosis. Conclusion. Pancreatic metastases are rare manifestation of FV-PTC and are usually sign of extensive disease and conventional diagnostic tools may remain to reach the diagnosis.

Studies on the consistency of internally taken contrast medium for pancreas CT

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Matsushima, Kishio; Mimura, Seiichi; Tahara, Seiji; Kitayama, Takuichi; Inamura, Keiji; Mikami, Yasutaka; Hashimoto, Keiji; Hiraki, Yoshio; Aono, Kaname

1985-02-01

A problem of Pancreatic CT scanning is the discrimination between the pancreas and the adjacent gastrointestinal tract. Generally we administer a dilution of gastrografin internally to make the discrimination. The degree of dilution has been decided by experience at each hospital. When the consistency of the contrast medium is low in density, an enhancement effect cannot be expected, but when the consistency is high, artifacts appear. We have experimented on the degree of the dilution and CT-No to decide the optimum consistency of gastrografin for the diagnosis of pancreatic disease. Statistical analysis of the results show the optimum dilution of gastrografin to be 1.5%.

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

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

Science.gov (United States)

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.

Dual phase helical CT: diagnosis value for early pancreatic carcinoma

International Nuclear Information System (INIS)

Shen Bingqi; Zhang Ling; Zheng Keguo; Xu Dasheng

2006-01-01

Objective: To study dual-phase helical CT for the evaluation of early pancreatic cacinoma. Methods: Dual-phase helical CT was performed on 21 patients with early pancreatic carcinoma. In the enhanced imaging the contrast material was intravenously injected in a dose of 1.5 ml/kg at a rate of 3 ml/s. The image acquisition of the lesion in pancreatic phase (PP) and portal venous phase (PVP) were started at 35 seconds and 65 seconds after the start of the injection respectively. The enhancement of normal pancreas and tumor during the two phases was observed and compared. All data were statistically analyzed. Results: Tumor-pancreas contrast was significantly greater in PP (45.16±113.23) HU than in PVP (23.15±12.44) HU (t=2.13, P<0.01). Conclusion: Dual-phase helical CT scan for pancreas, including the imaging of the pancreatic and portal , venous phase, can be applied as an optimal selection. It can delineate early pancreatic carcinoma clearly and provide more information for the diagnosis of the lesion. The tumor-pancreas contrast was much higher' in PP than in PVP. (authors)

File list: ALL.Emb.20.AllAg.Embryonic_pancreas [Chip-atlas[Archive

Lifescience Database Archive (English)

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File list: ALL.Emb.50.AllAg.Embryonic_pancreas [Chip-atlas[Archive

Lifescience Database Archive (English)

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Lifescience Database Archive (English)

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

Lifescience Database Archive (English)

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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 ...

An appraisal of intraoperative radiotherapy for pancreas cancer

Energy Technology Data Exchange (ETDEWEB)

Gotoh, Mitsukazu; Monden, Morito; Sakon, Masato; Kanai, Toshio; Umeshita, Koji; Ikeda, Hiroshi; Mori, Takesada (Osaka Univ. (Japan). Faculty of Medicine)

1993-03-01

Intraoperative radiotherapy (IORT) which was originally used for unresectable cancer has been applied to the cases after pancreas resection. However, it has not been clarified which stages of patients will have the beneficial effect of IORT on their prognosis. In this study, IORT after pancreas resection was appraised on the basis of the patient prognosis. Seventy-two pancreatectomized patients including 6 patients of Stage I, 18 of Stage II, 25 of Stage III and 23 of Stage IV, which was determined by the general rules for cancer of the pancreas in Japan Pancreas Society were employed in this study. Four Stage III and 15 Stage IV patients were treated with IORT (25-30 Gy) after pancreatectomy. Ten of these patients underwent postoperative external beam radiotherapy (22-48 Gy). All but one Stage I patient were currently alive. The median survival time (MST) of Stage II were 908 days and 2 were alive over 5 years after operation. MST of Stage III without IORT was 310 pod and all died within 906 pod. In contrast, all four Stage III patients were currently alive without a sign of recurrence (3, 10, 15, 57 pom). All Stage IV patients died within 462 pod, while three patients treated with IORT were alive over this period. These data suggest IORT improves the prognosis of Stage III patients when combined with radical resection of the pancreas. But it is not the case with the more advanced cases, where systemic anticancer adjuvant therapy might be indicated. (author).

An appraisal of intraoperative radiotherapy for pancreas cancer

International Nuclear Information System (INIS)

Gotoh, Mitsukazu; Monden, Morito; Sakon, Masato; Kanai, Toshio; Umeshita, Koji; Ikeda, Hiroshi; Mori, Takesada

1993-01-01

Intraoperative radiotherapy (IORT) which was originally used for unresectable cancer has been applied to the cases after pancreas resection. However, it has not been clarified which stages of patients will have the beneficial effect of IORT on their prognosis. In this study, IORT after pancreas resection was appraised on the basis of the patient prognosis. Seventy-two pancreatectomized patients including 6 patients of Stage I, 18 of Stage II, 25 of Stage III and 23 of Stage IV, which was determined by the general rules for cancer of the pancreas in Japan Pancreas Society were employed in this study. Four Stage III and 15 Stage IV patients were treated with IORT (25-30 Gy) after pancreatectomy. Ten of these patients underwent postoperative external beam radiotherapy (22-48 Gy). All but one Stage I patient were currently alive. The median survival time (MST) of Stage II were 908 days and 2 were alive over 5 years after operation. MST of Stage III without IORT was 310 pod and all died within 906 pod. In contrast, all four Stage III patients were currently alive without a sign of recurrence (3, 10, 15, 57 pom). All Stage IV patients died within 462 pod, while three patients treated with IORT were alive over this period. These data suggest IORT improves the prognosis of Stage III patients when combined with radical resection of the pancreas. But it is not the case with the more advanced cases, where systemic anticancer adjuvant therapy might be indicated. (author)

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

pancreatic tumours (p > 0.05). 68 Ga-DOTATOC uptake in the head of the pancreas is a common finding in patients undergoing 68 Ga-DOTATOC PET/CT. However, this finding most likely represents a physiological condition, especially if the uptake in the pancreatic head is similar to the uptake in the liver (uptake ratio head to liver SUV av < 1.4). Therefore, quantification is recommended to avoid false-positive diagnosis. Misalignment due to respiratory motion must always be taken into account. (orig.)

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

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

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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.)

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[Epidermoid cyst of the testis difficult to make a preoperative diagnosis on the echoic examination: a case report].

Science.gov (United States)

Yamamoto, Keisuke; Takada, Tsuyoshi; Momohara, Chikahiro; Komori, Kazuhiko; Honda, Masahito; Fujioka, Hideki

2003-04-01

A case of epidermoid cyst of the testis is presented. The patient was a 64-year-old man who complained of a painless mass in the left scrotum. Physical examination revealed a hen-egg sized enlargement of the left scrotal contents. The ultrasonographic appearance did not show a hyperechoic partition, which is called echogenic rim, a characteristic of this tumor on the echoic examination, and was homogeneous, almost similar to that of a normal testis. Because malignant testicular tumors could not be excluded preoperatively, excisional biopsy of the left testis was performed first. Histological diagnosis was an epidermoid cyst of the testis. As the left testis was almost completely occupied by the tumor and no normal testicular tissue was recognized, we performed orchiectomy additionally. Epidermoid cyst of the testis is a rare benign tumor that accounts for about 1 percent of all testicular tumors. It clinically resembles malignant testicular tumors, and orchiectomy is often performed for treatment. About 154 cases of testicular epidermoid cyst have been reported in the Japanese literature and are reviewed briefly here.

Brief preoperative smoking cessation counselling in relation to breast cancer surgery: a qualitative study

DEFF Research Database (Denmark)

Thomsen, Thordis; Esbensen, Bente Appel; Samuelsen, Susanne

2009-01-01

of cancer diagnosis was difficult for some women. They relapsed to smoking as an ingrown response to emotional distress. The smoking intervention heightened the women's awareness of their addiction to smoking; however, they expressed a need for prolonged smoking cessation support. For others, the smoking......AIM: To describe how women smokers with newly diagnosed breast cancer experienced brief preoperative smoking cessation intervention in relation to breast cancer surgery. BACKGROUND: Preoperative smoking cessation intervention is relevant for short- and long-term risk reduction in newly diagnosed...... cancer patients. Our knowledge of how patients with malignant diagnoses experience preoperative smoking intervention is however scarce. METHODS: A qualitative descriptive study that collected data through one-time individual, semi-structured interviews with 11 Danish women. Ricoeur's theory...

Coronary Heart Disease Preoperative Gesture Interactive Diagnostic System Based on Augmented Reality.

Science.gov (United States)

Zou, Yi-Bo; Chen, Yi-Min; Gao, Ming-Ke; Liu, Quan; Jiang, Si-Yu; Lu, Jia-Hui; Huang, Chen; Li, Ze-Yu; Zhang, Dian-Hua

2017-08-01

Coronary heart disease preoperative diagnosis plays an important role in the treatment of vascular interventional surgery. Actually, most doctors are used to diagnosing the position of the vascular stenosis and then empirically estimating vascular stenosis by selective coronary angiography images instead of using mouse, keyboard and computer during preoperative diagnosis. The invasive diagnostic modality is short of intuitive and natural interaction and the results are not accurate enough. Aiming at above problems, the coronary heart disease preoperative gesture interactive diagnostic system based on Augmented Reality is proposed. The system uses Leap Motion Controller to capture hand gesture video sequences and extract the features which that are the position and orientation vector of the gesture motion trajectory and the change of the hand shape. The training planet is determined by K-means algorithm and then the effect of gesture training is improved by multi-features and multi-observation sequences for gesture training. The reusability of gesture is improved by establishing the state transition model. The algorithm efficiency is improved by gesture prejudgment which is used by threshold discriminating before recognition. The integrity of the trajectory is preserved and the gesture motion space is extended by employing space rotation transformation of gesture manipulation plane. Ultimately, the gesture recognition based on SRT-HMM is realized. The diagnosis and measurement of the vascular stenosis are intuitively and naturally realized by operating and measuring the coronary artery model with augmented reality and gesture interaction techniques. All of the gesture recognition experiments show the distinguish ability and generalization ability of the algorithm and gesture interaction experiments prove the availability and reliability of the system.

Binary Decision Trees for Preoperative Periapical Cyst Screening Using Cone-beam Computed Tomography.

Science.gov (United States)

Pitcher, Brandon; Alaqla, Ali; Noujeim, Marcel; Wealleans, James A; Kotsakis, Georgios; Chrepa, Vanessa

2017-03-01

Cone-beam computed tomographic (CBCT) analysis allows for 3-dimensional assessment of periradicular lesions and may facilitate preoperative periapical cyst screening. The purpose of this study was to develop and assess the predictive validity of a cyst screening method based on CBCT volumetric analysis alone or combined with designated radiologic criteria. Three independent examiners evaluated 118 presurgical CBCT scans from cases that underwent apicoectomies and had an accompanying gold standard histopathological diagnosis of either a cyst or granuloma. Lesion volume, density, and specific radiologic characteristics were assessed using specialized software. Logistic regression models with histopathological diagnosis as the dependent variable were constructed for cyst prediction, and receiver operating characteristic curves were used to assess the predictive validity of the models. A conditional inference binary decision tree based on a recursive partitioning algorithm was constructed to facilitate preoperative screening. Interobserver agreement was excellent for volume and density, but it varied from poor to good for the radiologic criteria. Volume and root displacement were strong predictors for cyst screening in all analyses. The binary decision tree classifier determined that if the volume of the lesion was >247 mm 3 , there was 80% probability of a cyst. If volume was cyst probability was 60% (78% accuracy). The good accuracy and high specificity of the decision tree classifier renders it a useful preoperative cyst screening tool that can aid in clinical decision making but not a substitute for definitive histopathological diagnosis after biopsy. Confirmatory studies are required to validate the present findings. Published by Elsevier Inc.

Multislice CT for preoperative diagnosis of pancreatic cancer

International Nuclear Information System (INIS)

Horiguchi, Akihiko; Ishihara, Shin; Ito, Masahiro

2007-01-01

We investigated the ability of multislice (MS) CT to visualize and diagnose the progression of pancreatic cancer. With regard to local progression, good diagnosis was possible for detecting the invasion of the intrapancreatic bile duct, duodenum, portal vein, arteries and other organs, and liver metastasis. Sensitivity was high but specificity was not good for detecting the invasion of the anterior and posterior pancreatic tissue. This is thought to be because of the positive diagnosis with pancreatitis that accompanies cancer. Pancreatic plexus invasion was also thought to be a cause of the lipid elevation of the nerve plexus and decreased sensitivity accompanying pancreatitis. Identification of cancer invasion and tumor periphery changes based on concomitant pancreatitis also depends on the amount of fibrous stroma, but this will require further investigation. Factors other than the size of lymph node metastases also need to be investigated. MS-CT can provide detailed volume data in a short time and making it an essential test in diagnosing the stage of pancreatic cancer. (author)

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.

Zenker's diverticulum - diagnosis and therapy

Energy Technology Data Exchange (ETDEWEB)

Heindel, W; Raab, M

1987-08-01

Clinical, X-ray and endoscopic follow-up of patients operated on for Zenker's diverticulum (pharyngo-oesophageal diverticulum) via myotomy and diverticulectomy permits conclusions in respect of functional results of this therapeutic concept and the preoperative diagnosis that our study has proved to be necessary. Usually the diagnosis can be made on the basis of the characteristic anamnesis. It is confirmed by means of an oesophagogram, if necessary with a gastrointestinal passage. Besides visualisation of Zenker's diverticulum, attention must be paid especially to associated neuromuscular functional disturbances of the oesophagus. Preoperative endoscopy is necessary in individual cases only. In respect of therapy, it appears mandatory to perform a sufficiently extended (3-5 cm) myotomy of the pars transversa musculi cricopharyngei because of the frequently seen disturbance of coordination of the pharyngo-oesophageal sphincter, besides removing the diverticulum.

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

Magnetic resonance imaging of the pancreas in streptozotocin-induced diabetic rats: Gadofluorine P and Gd-DOTA.

Science.gov (United States)

Cho, Hye Rim; Lee, Youkyung; Doble, Philip; Bishop, David; Hare, Dominic; Kim, Young-Jae; Kim, Kwang Gi; Jung, Hye Seung; Park, Kyong Soo; Choi, Seung Hong; Moon, Woo Kyung

2015-05-21

To investigate the performance of Gadofluorine P-enhanced magnetic resonance imaging (MRI) on the diagnosis of diabetes in a streptozotocin (STZ) -induced diabetic rat model. Fischer 344 rats were treated with STZ. Rats not treated with STZ served as controls. T1-weighted MRI was performed using a 3T scanner before and after the injection of Gd-DOTA or Gadofluorine P (6 diabetic rats, 5 controls). The normalized signal intensity (SI) and the enhancement ratio (ER) of the pancreas were measured at each time point, and the values were compared between the normal and diabetic rats using the Mann-Whitney test. In addition, the values were correlated with the mean islet number. Optimal cut-off values were calculated using a positive test based on receiver operating characteristics. Intrapancreatic Gd concentration after the injection of each contrast media was measured using laser ablation-inductively coupled plasma-mass spectrometry in a separate set of rats (4 diabetic rats, 4 controls for Gadofluorine P; 2, 2 for Gd-DOTA). The normalized SI and ER of the pancreas using Gd-DOTA were not significantly different between diabetic rats and controls. With Gadofluorine P, the values were significantly higher in the diabetic rats than in the control rats 30 min after injection (P DOTA (0.967 vs 0.667, P = 0.085). An increase in normalized SI 30 min after Gadofluorine P was correlated with a decrease in the mean number of islets (r (2) = 0.510, P = 0.014). Intra-pancreatic Gd was higher in rats with Gadofluorine P injection than Gd-DOTA injection (Gadofluorine P vs Gd-DOTA, 7.37 vs 0.00, P < 0.01). A significant difference in the concentration of intrapancreatic Gd was observed between the control and diabetic animals that were sacrificed 30 min after Gadofluorine P injection (control vs diabetic, 3.25 ng/g vs 10.55 ng/g, P < 0.05) CONCLUSION: In this STZ-induced diabetes rat model, Gadofluorine P-enhanced MRI of the pancreas showed high accuracy in the diagnosis of diabetes.

Comparative considerations concerning scintigraphy, arteriography and reverse ductography in pancreas diseases

Energy Technology Data Exchange (ETDEWEB)

Romani, S; Oselladore, D; Feltrin, G P; Ravasini, R; Zacchi, C; Di Maggio, C; Vedaldi, R; Vio, S; Maffessanti, M; Perelli, R [Padua Univ. (Italy)

1975-01-01

Disregarding the actual nature of the diagnosis of pancreatic disease, scintigraphy with labeled selenomethionine significantly reveals pathological disorders, however general they may be. In the recognition of ''scintigraphically normal'' the homogeneous results of a linear scan are distributed on values of 85% and results with the gamma-camera on values of 88%. The scintigraphic response remains even more homogeneous with the pathologic pancreas, e.g. in chronic pancreatitis and cancer, where linear scintigraphy yields correct diagnoses in 84% and 92% of the cases, and the gamma-camera in 84% and 93% of the cases, respectively. In summary, scintigraphy offers an important identification of the normal, and a high percentage of correct diagnoses in the pathological realm; thus, it represents the most appropriate means for detection at the pancreatic level. The methodological choice based on clinical data first takes scintigraphic data and incorporates them with arteriography in the case of suspected carcinomas or with ductography when chronic pancreatitis is believed to exist. Arteriography has priority in the localization of adenomas, while ductography is relied upon in the diagnosis of pseudocysts.

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