Journal of the Pancreas最新文献

{"title":"Possible Involvement of Innate Lymphoid Cells in the Development of Chronic Inflammatory Pancreatic Diseases","authors":"Manami Ikemune, K. Uchida, M. Yanagawa, S. Tsukuda, T. Tomiyama, Toshihiro Tanaka, Y. Ando, T. Ikeura, Takashi Yamaguchi, T. Fukui, A. Nishio, K. Okazaki","doi":"10.36648/1590-8577.22.1.1-10","DOIUrl":"https://doi.org/10.36648/1590-8577.22.1.1-10","url":null,"abstract":"Introduction Type 1 autoimmune pancreatitis is a chronic fibro-inflammatory disorder. We previously reported the involvement of M2 macrophages and basophils in autoimmune pancreatitis. It is reported that Group 2 innate lymphoid cells (ILC2s) and basophils play an important role in asthma. Thus, this study investigated the roles of innate lymphoid cells in autoimmune pancreatitis. Subjects and methods We recruited 28 patients with autoimmune pancreatitis (25 men and 3 women; mean age, 68.4 years) who were not receiving steroid therapy, 10 patients with chronic pancreatitis (CP; 2 women and 3 men with idiopathic CP and 5 men with alcoholic CP; mean age, 65.9 years), and 30 healthy controls (HCs; 5 women and 25 men; mean age, 66.9 years). Peripheral ILCs were analyzed using flow cytometry. We also analyzed two types of ILC2s (lineage− CD127+ CD161+ c-Kit+/− CRTH2+ and lineage− CD25+ IL-33R+ cells). Results The proportions of ILC2s and ILC3s were significantly higher in the autoimmune pancreatitis (0.140% ± 0.083% and 0.055% ± 0.043%, respectively) and CP groups (0.119% ± 0.055% and 0.051% ± 0.040%, respectively) than in the HC group (0.054% ± 0.039% and 0.018% ± 0.017%, respectively). The proportion of ILC1s did not differ among three groups. There was no significant correlation between the counts of the two ILC2 types. Conclusion Elevated ILC2 and ILC3 counts may be involved in the development of chronic pancreatic inflammation.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"17 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Plea for Pancreatic Cancer","authors":"J. Davidwong","doi":"10.36648/1590-8577.21.22.121-122","DOIUrl":"https://doi.org/10.36648/1590-8577.21.22.121-122","url":null,"abstract":"","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69688858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solid Pseudopapillary Neoplasm of Pancreas-A 10 Year Experience from a Tertiary Care Referral Centre","authors":"D. Kapoor, S. Dubey, A. Perwaiz, Amanjeet Singh, A. Chaudhary","doi":"10.36648/1590-8577.22.2.42-46","DOIUrl":"https://doi.org/10.36648/1590-8577.22.2.42-46","url":null,"abstract":"Introduction Solid pseudopapillary tumours (SPN) of pancreas are increasingly being diagnosed and reported. Understanding the management of these tumours is getting better but still there are many unanswered questions. Materials and Methods this is a retrospective analysis of prospectively maintained surgical database at the department of GI Surgery and GI Oncology, Medanta, Gurugram, Haryana. The clinicopathological and surgical parameters of 34 patients who underwent surgery for SPN, over a 10 year period were analysed. Results All patients underwent surgical resection, which included 12 (35.3%) Whipple’s pancreatoduodenectomy, 4 (11.76%) central pancreatectomy, 11 (32.35%) spleen preserving distal pancreatectomy and 6 (17.65%) distal pancreatosplenectomy. Three patients were detected to have recurrence and were re-operated. Conclusion Surgical management of SPN yields good long term results despite recurrent or metastatic disease. Many deficiencies still remain in the understanding and management of this disease.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69689794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Acute Fulminant Pancreatitis in Patients Admitted to the Intensive Care Unit: A Retrospective Study","authors":"Y. Launey, T. Wallenhorst, A. Tawa, C. Rousseau, A. Foubert, Philippe Seguina","doi":"10.36648/1590-8577.22.2.47-54","DOIUrl":"https://doi.org/10.36648/1590-8577.22.2.47-54","url":null,"abstract":"Background/Objectives The term acute fulminant pancreatitis (AFP) has been proposed to define the most severely ill patients and those who are likely to die before they develop persistent organ failure. The objective of our study was to determine the risk factors for developing AFP in patients admitted to the intensive care unit (ICU). Methods This was a retrospective study conducted between January 2007 and May 2019 in a ICU. Patients ≥18 years old admitted to the ICU within 3 days of the onset of abdominal pain related to acute pancreatitis were included. We defined AFP according to the modified Marshall scoring system for organ dysfunction based on a score ≥ 2 involving at least 2 organ systems for at least 48 hours or ≤ 48 hours if the patient died during the first 7 days of hospitalization. Results Sixty-three patients were analyzed (AFP group, n=27 - non-AFP group, n=36). In multivariate analysis, AFP was associated with a lower level of fluid loading before ICU admission (OR [95%CI] = 0.89 [0.82; 0.97], p<0.001) and a higher modified Marshall score (OR [95%CI] = 2.31 [1.53; 3.49], p<0.001). On day 7, mortality was higher in the AFP group (48% vs. 3%, p<0.001), and 29% of patients with AFP died within 48 hours of admission to the ICU before developing persistent organ failure. Conclusions A lower level of fluid resuscitation prior to admission to the ICU and a higher modified Marshall score on ICU admission were independently associated with higher risks of developing AFP.","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69690167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There any Survival Benefit of Maintenance Chemotherapy Following Adjuvant Chemotherapy in Patients with Resected Pancreatic Cancer Patients with Post-Surgery Elevated CA 19-9?","authors":"Muhammad Wasif Saif,&nbsp;Melissa H Smith,&nbsp;Martin D Goodman,&nbsp;Ronald R Salem","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pancreatectomy offers only potential for cure but is only possible in a minority of patients. Even in those patients who receive adjuvant chemotherapy, majority of them succumb to death due to metastases. Radiation Therapy Oncology Group 9704 showed that post-surgery CA 19-9 levels are an important predictor of survival. European study group for pancreatic cancer-3 showed that completion of all 6 cycles of adjuvant chemotherapy was an independent prognostic factor. Any survival benefit of an intensified chemotherapy strategy has not been demonstrated in patients with persistently elevated CA 19-9 following surgery. The object of this study was to investigate any benefit of maintenance chemotherapy following adjuvant in these patients.</p><p><strong>Methods: </strong>Twenty patients with R0 surgery of pancreatic cancer who received adjuvant chemotherapy with post-surgery elevated CA 19-9 but no radiographic evidence of cancer was identified from 2005-2017. Either biopsy or positron emission tomography scan determined recurrence of cancer. Efficacy endpoints including overall survival and disease-free survival were assessed.</p><p><strong>Results: </strong>Maintenance and additional chemotherapeutic agents included 5-FU, capecitabine, platinum agents, irinotecan and nab-paclitaxel. CA 19-9 normalized in 3 patients while 22 persisted to be elevated or had further increase in the marker. Two patients underwent metastatectomy. Median disease-free survival was 14.5m (9-18), OS 29m (19-96) and OS rates were 80%, 50% at 1 and 2 years respectively.</p><p><strong>Conclusions: </strong>We believe that the longer overall survival of our patients with elevated CA 19-9 post-surgery was due to maintenance and additional chemotherapy following planned 6-months of adjuvant therapy, close monitoring with monthly CA 19-9 and 3-monthly computed tomography scans. Our study also underlines importance of collecting pre-surgery CA 19-9 and complete staging including chest. Prospective study aiming to evaluate role of maintenance or intensified chemotherapy or targeted agents are indicated.</p>","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"21 5","pages":"74-80"},"PeriodicalIF":0.2,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7515691/pdf/nihms-1629675.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38428456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Neoadjuvant Therapy Improve Outcome in Resectable PC? Gastrointestinal Cancers Symposium 2019.","authors":"Maged Ghaly,&nbsp;Muhammad Wasif Saif","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"20 5","pages":"155-158"},"PeriodicalIF":0.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043202/pdf/nihms-1056086.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37681345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplified/Same Day(s)-GOLF as First-line Treatment of Metastatic Carcinoma of Unknown Primary (CUP), Suggestive of Pancreatobiliary Tumors.","authors":"Muhammad Wasif Saif,&nbsp;Komal Wasif,&nbsp;Martin D Goodman,&nbsp;Sanjay Hegde,&nbsp;Mark Sterling,&nbsp;Robert Yacavone,&nbsp;Sunny Jaiswal,&nbsp;Barbara Weinstein,&nbsp;Kevin Daly,&nbsp;Valerie Relias","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Carcinoma of unknown primary represents a therapeutic challenge in oncological practice. Evidence lacks to support particular chemotherapy selection and empirical therapies are commonly extrapolated from data on patients where primary tumor site is known. Gemcitabine, Oxaliplatin, Leucovorin and 5-Fluorouracil was previously developed to treat pancreatic cancer. These agents have also demonstrated activities in other gastrointestinal malignancies. Considering promising anti-tumor effects of GOLF, we performed a retrospective study to investigate anti-tumor activity and safety of a simplified Gemcitabine, Oxaliplatin, Leucovorin and 5-Fluorouracil in patients with Carcinoma of unknown primary in whom immunohistostaining was suggestive of either upper gastrointestinal cancers or pancreatobiliary cancers.</p><p><strong>Methods: </strong>This retrospective study included 18 patients recorded to have a diagnosis of Carcinoma of unknown primary between Aug 2010-Dec 2015, who received biweekly G 1000 mg/m², O 85 mg/m², L 200 mg/m² and F 2400 mg/m² over 46-h on day 1 with pegfilgrastim on day 3 every 14 days. IHC staining pattern favored upper GI origin, including stomach, bile duct or pancreas. Tumor assessments were repeated every 8 weeks.</p><p><strong>Results: </strong>Median age was 67 years (range: 46-76), with ECOG PS<2, and 50% were women. Median number of cycles was 4 (range: 3-14). 7 partial responses were obtained (RR: 39%) and 7 achieved stable disease with overall disease control of 78%. Median time to tumor progression was 4 months (range: 2-9). 8 (44%) patients received liver-directed therapy and 1 underwent HIPEC (5%). Median survival time was 10.5 months (range: 6.7-14.5) and 1-year overall survival rate was 35%. Grade 3-4 toxicities included neutropenia, febrile neutropenia, thrombocytopenia, nausea, diarrhea, mucositis and oxaliplatin-induced neuropathy.</p><p><strong>Conclusion: </strong>Simplified Gemcitabine, Oxaliplatin, Leucovorin and 5-Fluorouracil regimen appears to be feasible with promising activity for Carcinoma of unknown primary and deserves to be evaluated in future trials.</p>","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"20 5","pages":"121-124"},"PeriodicalIF":0.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043200/pdf/nihms-1060060.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37681344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparable Responses in Male and Female Mice to Cerulein-Induced Chronic Pancreatic Injury and Recovery.","authors":"Tolulope F Obafemi,&nbsp;Peter Yu,&nbsp;Jing Li,&nbsp;Joy M Davis,&nbsp;Ka Liu,&nbsp;Binglu Cheng,&nbsp;Xiurong Zhao,&nbsp;Qiang Shen,&nbsp;Mamoun Younes,&nbsp;Tien C Ko,&nbsp;Yanna Cao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>The cerulein-induced mouse pancreatitis model is a well-established, commonly used representation of human chronic pancreatitis pathology. Although studies report sex-dependent differences in human chronic pancreatitis, there are no studies in this model directly comparing sex response to pancreatic injury and recovery. Therefore, we designed a study to investigate whether sex- dependent differences in chronic pancreatitis injury and recovery exist in the cerulein-induced pancreatitis model.</p><p><strong>Methods: </strong>Adult male and female C57BL/6 mice were administered cerulein (50 μg/kg, 5 hourly intraperitoneal injections/day, 3 days/week) for 4 weeks to induce chronic pancreatitis; control mice received normal saline injections. Pancreata and blood were harvested at 4 days (as injury group) or 4 weeks (as recovery group) after the last injection. Amylase secretion was measured from the serum. Acinar injury was scored on H&E sections. Fibrosis was assessed by Sirius Red and collagen immunofluorescence staining.</p><p><strong>Results: </strong>Compared to time-matched controls, injury group displayed decreased body and pancreas weight, and increased acinar injury and fibrosis, with no significant differences between males and females. Recovery group demonstrated recovery of body weight, partial recovery of pancreas weight, reversal of acinar injury, and partial reversal of fibrosis, with no significant differences between males and females. Amylase secretion/body weight was similar across all groups.</p><p><strong>Conclusions: </strong>Male and female mice of the cerulein-induced chronic pancreatitis demonstrate similar responses to chronic pancreatitis injury and recovery. Although this model may not sufficiently emulate sex-dependent responses in human chronic pancreatitis, our study supports that both sexes of mice from this model can be used for the study of chronic pancreatitis.</p>","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"19 5","pages":"236-243"},"PeriodicalIF":0.2,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327960/pdf/nihms-993638.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36857916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancrelipase-Induced Hypersensitivity Reaction: Case Report and Review of Literature.","authors":"Jason A Adler,&nbsp;Muhammad W Saif","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Drug-induced exanthems are commonly associated with NSAIDs, antibiotics, and anti-epileptics. Pancrelipase is frequently used for conditions resulting in pancreatic exocrine insufficiency. Published case reports of pancrelipase hypersensitivity focus on the respiratory manifestations.</p><p><strong>Case report: </strong>Here we report a case of skin hypersensitivity resulting from pancrelipase use. To further assess this association, we used a Naranjo nomogram, which determines the likelihood that an adverse drug reaction is the result of the drug itself. Our patient had a score of seven, suggesting our patient had a probably adverse drug reaction.</p><p><strong>Discussion: </strong>As pancrelipase is a commonly prescribed drug, clinicians should be aware of the potential hypersensitivity skin reactions associated with pancrelipase.</p>","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"19 5","pages":"273-275"},"PeriodicalIF":0.2,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6217990/pdf/nihms-993639.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36655089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Metastasis of Gastroenteropancreatic Neuroendocrine Tumors (GEP-Nets).","authors":"Rohit Dhingra,&nbsp;Julie Y Tse,&nbsp;Muhammad Wasif Saif","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Gastroenteropancreatic neuroendocrine tumors are neoplasms commonly found within the gastrointestinal tract that originate from endocrine cells. These are slow progressive tumors and often metastasize to other elements of the gastrointestinal tract including the liver. Consequently, these tumors release hormones including serotonin and/or histamine that are responsible for the symptoms including intermittent flushing and diarrhea. Metastasis of gastroenteropancreatic neuroendocrine tumors, although rare, is possible and may extend to local lymph nodes and viscera.</p><p><strong>Case report: </strong>Our patient was a 69-year-old female who initially presented with postprandial abdominal pain, nausea, vomiting, and later was diagnosed with gastroenteropancreatic neuroendocrine tumors following surgical resection in 2014. Restaging after surgery showed regional lymph node involvement and hepatic metastasis. Of note she did not have a pre-operative computed tomography scan. She was started on octreotide, and later switched to lanreotide. In the interim, she did not have any positive findings on serial octreoscans depicting the skin lesion that was performed in the interim period every six months. However, she noticed a cutaneous mass in the upper right flank mass in 2016, which was followed up by a dermatologist. In 2017, the mass grew in size and hence biopsied which showed neuroendocrine tumors consistent with her primary tumor.</p><p><strong>Discussion: </strong>Gastroenteropancreatic neuroendocrine tumors often metastasize to lymph nodes and liver but rarely can involve the skin and present as firm papules as found in our patient. Cutaneous metastasis of gastroenteropancreatic neuroendocrine tumors often has high morbidity and mortality and is usually associated with a primary lesion in the bronchopulmonary system. However, as demonstrated in this case report, cutaneous metastasis can originate from the gastrointestinal tract, including the small intestine as well.</p>","PeriodicalId":47280,"journal":{"name":"Journal of the Pancreas","volume":"19 5","pages":""},"PeriodicalIF":0.2,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6217987/pdf/nihms-993637.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36655088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}