Pancreatic disorders & therapy最新文献

{"title":"Pancreatic Cancer Resection and Incidental Congenital Anomaly of the Inferior Vena Cava","authors":"R. Casadei, Selene Bogoni, C. Ricci, F. Minni","doi":"10.4172/2165-7092.1000165","DOIUrl":"https://doi.org/10.4172/2165-7092.1000165","url":null,"abstract":"The inferior vena cava, due to its complex embryogenesis and relationship with other abdominal and thoracic structures, may develop abnormally. The anomalies and variations of inferior vena cava anatomy are very rare occurring in approximately 0.3% of the population. Among these latter, duplication of the inferior vena cava has an incidence of 2–3%. Usually, right inferior vena cava dominates and left inferior vena cava terminates in the right inferior vena cava at the level of the left renal vein. This condition may become problematic in surgical procedures and diagnoses. Herein, a very rare anatomic variation of inferior vena cava duplication was described in a patient who underwent pancreatic resection for pancreatic cancer.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"19 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2015-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74892319","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":"Novel Combination Therapy Boosts the Host Immune System, Destroys Free Radicals and Targets the Critical Flaw in Chronic Pancreatic Disease","authors":"T. C. Peterson","doi":"10.4172/2165-7092.1000E143","DOIUrl":"https://doi.org/10.4172/2165-7092.1000E143","url":null,"abstract":"Aim: To investigate the role of combination therapy using the cytokines antagonist, pentoxifylline in combination with a novel powerful antioxidant derived from grape product in the treatment of pancreatic disease. \u0000Methods and Research Plan: We want to acknowledge that much of the groundwork has already been done demonstrating the positive effect of antioxidant therapy in pancreatic diseases including pancreatitis, chronic pancreatic disorders, fibrosis and even pancreatic cancer. It is also well accepted that pentoxifylline, originally described as a drug to aid blood circulation via actions on adenosine triphosphate, is also an effective and efficient inhibitor of platelet derived growth factor and other cytokines essential to the inflammatory and fibrotic processes. We have understood for several years that this immunopharmacological drug inhibits other key signalling molecules in the immune system, ultimately preventing the collagen synthesis and deposition which is critical in pancreatic, hepatic and intestinal fibrosis. Our aim is to combine these two forms of therapy in patients with chronic pancreatic disease while simultaneously optimizing conditions using as our basis the dramatic results that have already been reported widely in literature, by world class investigators. \u0000Results and Conclusion: Results to date are promising. Our results presented here clearly indicate that pentoxifylline will block a process in a relatively rare form of intestinal fibrosis called collagenous colitis. This was our proof of concept. In this very selective disease the critical step is collagen deposition. Collagen synthesis resulting in deposition is the key factor involved and has a direct effect on the outcome in these patients with collagenous colitis. We were able to show that pentoxifylline would effectively reduce collagen deposition in the colons of a group of relatively heterogeneous patients with their one consistent variable being biopsy proven colonic collagen deposition and an elevated FSI or fibrogenic stimulation index. Our results also clearly indicate that the reduction in colonic collagen deposition occurring with pentoxifylline therapy is accompanied by a measurable DII or drug inhibition index and that the FSI was predictive of which cohort of patients would respond to this drug. Pentoxifylline was an effective anti-fibrotic agent while having little if any side effect and working in a very effective way to reduce the signs and symptoms of the disease. Long before we were able to see the histological proof in colonic biopsies, patients who prior to treatment showed a predictive DII were already reporting beneficial effects on their symptoms and clinicians were reporting improvement in clinical signs. At time points during the treatment period, biopsies revealed that the collagen was diminishing and results also indicate that the rate of reduction of collagen deposition related to the chronicity of the disease itself. The combination of","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"48 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2015-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90629480","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":"Ethics and Experimental Medicine Progress","authors":"V. Coulic","doi":"10.4172/2165-7092.1000E142","DOIUrl":"https://doi.org/10.4172/2165-7092.1000E142","url":null,"abstract":"According to Larousse Encyclopaedic Dictionary (Ed. 1987), “Ethics” is defined as a doctrine of humans’ happiness and the means to access to this aim. It is also a specific teaching of the rules of living. As to Bioethics, it is considered as the “science of the medical morality”. “Progress” is characterized as a movement ahead and is supposed to contribute to increase human welfare. “Experimentation” consists in the use of due techniques in order to try to prove the rightness of a new proposal, to verify hypotheses. A hypothesis itself is defined as a proposal coming derived from observation or induction and necessitating verification, from which consequences may be draught. We shall not discuss the definitions, but only some situation developing during the last years in relation with the rising influence of so called ethic pressure in most of the medicine domains. This situation may interfere with the real possibilities for experimental medicine going ahead, with further development and hence probabilities of significant discoveries, innovations, inventions allowing mankind to progress. Presently experimental medicine domain includes both human and animal sphere.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"8 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2015-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85840644","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":"Role of Fibroblast Growth Factor Receptor 2 in Pancreatic Cancer:Potential Target for New Therapeutic Approach?","authors":"E. Vescarelli, S. Ceccarelli, A. Angeloni","doi":"10.4172/2165-7092.1000164","DOIUrl":"https://doi.org/10.4172/2165-7092.1000164","url":null,"abstract":"Fibroblast growth factors and their receptors play a key role in cell proliferation, migration and differentiation. Fibroblast growth factor receptor 2 (FGFR2) is involved in carcinogenesis and its altered expression has been shown in several tumors, such as breast, thyroid and pancreatic cancer. The two isoforms of FGFR2 gene, FGFR2-IIIb (also known as KGFR) and FGFR2-IIIc have been shown to exert differential roles in pancreatic cancer. FGFR2-IIIc supports pancreatic cell proliferation, while overexpression of FGFR2-IIIb is correlated to major invasion and metastasis formation. This review focuses on the role of FGFR2 signaling in pancreatic adenocarcinoma and the potential use of FGFR2 tissutal expression as a predictive and/or prognostic marker. Moreover, it will discuss about the potential use of strategies for FGFR2 signaling inhibition in the treatment of pancreatic cancer.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"48 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2015-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84711686","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":"Pancreatitis In Pregnancy: What has Remained The Same and What has Changed?","authors":"N. Machado","doi":"10.4172/2165-7092.1000E140","DOIUrl":"https://doi.org/10.4172/2165-7092.1000E140","url":null,"abstract":"Pregnancy associated pancreatitis (PAP) is uncommon with a reported incidence of approximately one in 25001 to 10,0002 live births. Literature reveals a wide range of incidence, clinical outcomes and risk factors related to PAP. The incidence is reported to vary between 0.1% to 0.008% of pregnancy [1-7]. Even though the incidence is still rare, the potential complication is doubled compared to non-pregnant patients, as it deals with 2 lives. In evaluating PAP it is important to address four important queries. 1) does the patient have acute pancreatitis (establishing the diagnosis and ruling out potential differential diagnosis); 2) what is the severity, if the diagnosis of acute pancreatitis is established; 3) is it of biliary origin and if so, is there persisting CBD obstruction or complication like cholangitis; 4) which trimester of pregnancy is the patient in and is there any sign of preterm labour or abortion. This editorial addresses the etiopathogenesis, complications and management and notes what has remained the same and what has changed in recent times regarding PAP.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"6 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2015-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74562801","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":"Early Education Can Prevent Early Cancer; Alternate Strategy to Defeat Cancer","authors":"A. Shehzad, N. Shahzadi","doi":"10.4172/2165-7092.1000E141","DOIUrl":"https://doi.org/10.4172/2165-7092.1000E141","url":null,"abstract":"Each year the American Cancer Society figures out the numbers of new cancer cases and deaths that estimates tooccur in the United States. Currently, it has been reported that a total of 1,658,370 (848,200 male and 810,170 female) new cancer cases and 589,430 (312,150 male and 277,280 female) deaths due to cancer are expected to occur in the United States in 2015 [1]. In spite of research advancements for cancer prevention, diagnosis, and treatment, breast cancer remains the second leading cause of cancer-related deaths in women in the United States. In 2015, it is estimated that total of 234,190 (2,350 male and 231,840 female) new cases of breast cancers are expected to be diagnosed [1].","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"69 1","pages":"1-1"},"PeriodicalIF":0.0,"publicationDate":"2015-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75776666","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":"Serum level of Urokinase Plasminogen Activator (uPA) Correlates with the Survival of Patients with Pancreatic Ductal Adenocarcinoma (PDAC)","authors":"K. Winter, P. SzczeÅniak, M. Bulska, A. Kumor-Kisielewska, A. Durko, A. Gąsiorowska, D. Orszulak-Michalak, E. MaÅeckaPanas","doi":"10.4172/2165-7092.1000163","DOIUrl":"https://doi.org/10.4172/2165-7092.1000163","url":null,"abstract":"Background: Urokinase plasminogen activator (uPA) is a serine protease which transforms inactive plasminogen into active plasmin. UPA plays an important role in neoplasm progression, cell growth and metastases through degradation of proteins in basement membranes and extracellular matrix. The aim of the study was the analysis of serum uPA concentration in patients suffering from pancreatic ductal adenocarcinoma (PDAC) and chronic pancreatitis (CP) in order to determine its possible diagnostic and prognostic value. \u0000Methods: A study group involved 90 patients: 40 patients with PDAC, 30 patients with CP and 20 healthy individuals. UPA serum concentration was evaluated with ELISA. \u0000Results: We observed the threefold increase of uPA serum concentration in patients with PDAC (3,23 ng/ml), twofold increase of uPA serum concentration in patients with CP (2,18 ng/ml) compared to the control group (1,01 ng/ ml) (PDAC vs CP p<0,01; PDAC vs control p<0,01; CP vs control p<0,01). We revealed significant positive correlation between uPA serum level and CA19-9 (r=0.305 p<0,05) in all analyzed groups. We also found the significant correlation between serum uPA concentration and the survival time. Higher uPA concentration was observed in patients with shorter survival time (r=-0,391; p<0,05). Significant differences were present between uPA levels lower and greater than 2 ng/ml and the patients survival time (p<0,05). \u0000Conclusions: The presented results confirm the negative prognostic role of high serum uPA concentration in pancreatic cancer patients. The significant positive correlation between uPA serum concentration and CA19-9 provides new insights into the potential role of uPA in pancreatic cancer diagnosis.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"63 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2015-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74028414","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":"Postcholecystectomy Syndrome: From Pathophysiology to Differential Diagnosis - A Critical Review","authors":"L. Madácsy, Z. Dubravcsik, A. Szepes","doi":"10.4172/2165-7092.1000162","DOIUrl":"https://doi.org/10.4172/2165-7092.1000162","url":null,"abstract":"Cholecystectomy has an excellent therapeutic outcome. Up to 15-20 % of cholecystectomized patients however, continue to have a variety of gastrointestinal symptoms. Post-cholecystectomy syndrome (PCS) can be defined as symptoms of biliary colic or persistent right upper quadrant (RUQ) abdominal pain with or without dyspepsia, which are similar to that experienced by the patient before cholecystectomy. PCS continue to be present as a diagnostic and therapeutic challenge. The aim of this paper was to critically review the literature about the magnitude of the problem and the possible pathophysiological explanations of PCS.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"108 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2015-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81599160","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":"Diagnostic Utility of Reduced Radiation Dose Non-Contrast-Enhanced CT with Iterative Reconstruction for Screening in High-Risk Individuals with Pancreatic Cancer: An Anthropomorphic Phantom Study","authors":"H. Mori, Yasunari Yamada, M. Kiyonaga, Tomoaki Shiroo, T. Yoshitake, S. Matsumoto, R. Takaji, M. Okahara, T. Itoh","doi":"10.4172/2165-7092.1000161","DOIUrl":"https://doi.org/10.4172/2165-7092.1000161","url":null,"abstract":"Background: Previous studies showed that the dilated main pancreatic duct (MPD) and pancreatic cysts were the important predictors of the subsequent development of pancreatic cancer. The purpose of this study was to reveal the utility of non-contrast reduced radiation dose CT with iterative reconstruction for screening in high risk pancreatic cancer individuals by assessing the dilated MPD and cysts by using abdominal phantoms. \u0000Materials and methods: Two phantoms with normal and abnormal pancreas with dilated MPD (5 mm) and cysts (5 mm, 10 mm and 15 mm) were constructed. Each phantom was scanned by ten images using following three protocols: 120 kVp and 120mA with filtered back projection (FBP) algorithm (120 kVp-FBP), 80 kVp and 168mA with FBP algorithm (80 kVp-FBP), and 80 kVp and 168mA with sinogram affirmed iterative reconstruction (SAFIRE) (80 kVp-SAFIRE). The image noise and contrast-to-noise ratio (CNR) of the 15mm cyst were assessed. The radiation dose was assessed with the volume CT dose index (CTDIvol). Two radiologists scored the image quality and conspicuity of the dilated MPD and cysts. \u0000Results: Mean image noise significantly decreased from 80 kVp-FBP images to 80 kVp-SAFIRE and 120 kVp-FBP images (p < 0.001). The CNR significantly increased from 80 kVp-FBP images to 120 kVp-FBP and 80 kVp-SAFIRE images (p < 0.05). Image quality was significantly lower in the 80 kVp-FBP images than in 120 kVp-FBP and 80 kVp- SAFIRE images in both readers (p < 0.05). The conspicuity point for the dilated MPD and three cysts was higher in 80 kVp-SAFIRE images than in 80 kVp-FBP and 120 kVp-FBP images. CTDIvol was reduced by 60 % at 80 kVp protocol. \u0000Conclusion: Non-contrast 80 kVp-SAFIRE CT protocol allowed for higher conspicuity of dilated MPD and cysts at a reduced radiation dose compared with 120 kVp-FBP protocols.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"35 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2015-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77679893","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":"The Atlanta 2012 versus the Determinant-Based Classifications for Acute Pancreatitis: Which One is Better?","authors":"L. Mircea, Negoi Ionut, L. Ion, P. Sorin, M. Gabriel, S. Hostiuc, Beuran Mircea","doi":"10.4172/2165-7092.1000160","DOIUrl":"https://doi.org/10.4172/2165-7092.1000160","url":null,"abstract":"Objective: New research on Acute Pancreatitis (AP) led to new classifications of this unpredictable disease and presently two of them are disputing the supremacy. Our aim is to compare the Atlanta 2012 Classification with the Determinant Based Classification in terms of clinical applicability and accuracy. \u0000Method: We performed retrospective analysis of all consecutive cases of AP managed in our tertiary, universityaffiliated emergency center during a period of 12 months. The patients were divided into severity groups according to the Atlanta 2012 and the Determinant-Based Classification. The main outcomes that we used for evaluation were hospital length of stay (H_LOS), intensive care unit (ICU) admission, ICU length of stay (ICU_LOS) and mortality. \u0000Results: 226 patients met the inclusion criteria. Most of the patients are male (61.9%), on the sixth decade of life (mean age: 53.8), biliary stones being the most common etiology of AP (39.4%). Using the aria under the curve (AUC) to compare the predictive accuracy of ICU Admission we found that AUC for the Determinant Based Classification is higher compared to AUC for the Atlanta 2012 (0.973 versus 0.961). AUC is similar for both the Atlanta 2012 Classification and DBC in predicting mortality (0.986 and 0.984 respectively). Both classifications provided similar results considering H_LOS and ICU_LOS. \u0000Conclusions: The Atlanta 2012 and the DBC both predict with increased accuracy the clinical prognosis of patients with AP. The Determinant Based Classification has a slight advantage over the Atlanta 2012 Classification because it succeeded in offering a better prediction for the ICU Admission and ICU_LOS. Although their clinical applicability is similar, there are few aspects that can be improved and worldwide consensus is necessary for uniformity of scientific research.","PeriodicalId":89708,"journal":{"name":"Pancreatic disorders & therapy","volume":"8 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2015-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87952522","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}