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- Fish consumption and risk of non-gallstone-related acute pancreatitis: a prospective cohort study. [Journal Article]
- Am J Clin Nutr 2015 Jan; 101(1):72-8.
Epidemiologic data on the role of diet in acute pancreatitis are sparse.We examined the association of total fish consumption, as well as of consumption of fatty fish and lean fish separately, with risk of non-gallstone-related acute pancreatitis.We used data from 2 prospective cohorts, the Cohort of Swedish Men and the Swedish Mammography Cohort, that included 39,267 men and 32,191 women who were aged 45-84 y at the start of a 13-y follow-up period (1998-2010). Fish consumption was assessed by using a food-frequency questionnaire at baseline, and cases of incident non-gallstone-related acute pancreatitis were identified by linkage to the Swedish National Patient Register. HRs were estimated by using Cox proportional hazard models.During a total follow-up of 860,176 person-years, 320 cases (209 cases in men and 111 cases in women) of incident non-gallstone-related acute pancreatitis were identified. We observed that total fish consumption ≤2.0-3.0 servings/wk was associated with a significantly decreased risk of the disease (P-nonlinearity = 0.017). In comparison with 0.9 servings/wk, multivariable-adjusted HRs were 0.86 (95% CI: 0.76, 0.96), 0.77 (95% CI: 0.62, 0.96), and 0.85 (95% CI: 0.65, 1.10) for 1.4, 2.4, and 3.5 servings/wk, respectively. In the analysis of fatty fish and lean fish, we observed that the consumption of each subtype had a similarly shaped association with risk of non-gallstone-related acute pancreatitis as that observed for total fish consumption, although neither was significant. Multivariable-adjusted HRs were 0.83 for fatty fish (95% CI: 0.65, 1.04) and 0.87 for lean fish (95% CI: 0.69, 1.11) when 0.6-2.0 servings/wk was compared with ≤0.5 servings/wk.Our data suggest that the consumption of total fish (fatty fish and lean fish combined) may be associated with decreased risk of non-gallstone-related acute pancreatitis. The Swedish Mammography Cohort was registered at clinicaltrials.gov as NCT01127698. The Cohort of Swedish Men was registered at clinicaltrials.gov as NCT01127711.
- EUS is superior for detection of pancreatic lesions compared with standard imaging in patients with multiple endocrine neoplasia type 1. [Journal Article]
- Gastrointest Endosc 2015 Jan; 81(1):159-167.e2.
In multiple endocrine neoplasia type 1 (MEN1), pancreatic neuroendocrine tumors (pNETs) are the leading MEN1-related cause of death.To evaluate EUS and (11)C-5-hydroxytryptophan positron emission tomography ((11)C-5-HTP PET), compared with the recommended screening techniques in MEN1 patients for early detection of pNETs.Cross-sectional study.Tertiary-care university medical center.This study involved 41 patients with a proven MEN1 mutation or with one MEN1 manifestation and a mutation carrier as a first-degree family member, with recent screening by abdominal CT or magnetic resonance imaging (MRI) and somatostatin receptor scintigraphy (SRS).EUS by using a linear Pentax echoendoscope and Hitachi EUB-525 and (11)C-5-HTP PET.Patient-based and lesion-based positivity for pNET was calculated for all imaging techniques. The McNemar test was used to compare the yield of the 4 imaging techniques.In 35 of 41 patients, 107 pancreatic lesions were detected in total. EUS detected 101 pancreatic lesions in 34 patients, (11)C-5-HTP PET detected 35 lesions in 19 patients, and CT/MRI + SRS detected 32 lesions in 18 patients (P < .001). (11)C-5-HTP PET performed similarly to CT/MRI + SRS and better compared with SRS only (13 lesions in 12 patients), both at a patient-based and lesion-based level (P < .05).Single-center study.EUS is superior to CT/MRI + SRS for pancreatic lesion detection in patients with MEN1. In this setting, (11)C-5-HTP PET is not useful. We recommend EUS as the first-choice pancreas imaging technique in patients with MEN1. (NTR1668.).
- Pancreatic Carcinoma in an African Clawed Frog (Xenopus laevis). [Journal Article]
- Comp Med 2014; 64(6):421-3.
This report describes the histologic features of a pancreatic carcinoma in an adult female African clawed frog (Xenopus laevis). The animal was found to be in poor body condition and subsequently euthanized for a complete necropsy. Histologically, the pancreas was effaced by packets of polyhedral cells consistent with a pancreatic islet cell carcinoma. Metastatic disease was not identified. Pancreatic tumors are uncommon in amphibians, and this report is the first to describe a pancreatic carcinoma in an African clawed frog.
- A case of undifferentiated carcinoma of the pancreas mimicking main-duct intraductal papillary mucinous neoplasm (IPMN). [JOURNAL ARTICLE]
- Abdom Imaging 2014 Dec 21.
We report here a rare case of undifferentiated carcinoma of the pancreas mimicking main-duct intraductal papillary mucinous neoplasm. In an 80-year-old woman, an approximately 8-mm papillary mass was incidentally detected at the downstream edge of a dilatated main pancreatic duct lumen on CT and MRI. Main pancreatic duct dilatation in the pancreatic body and tail and parenchymal atrophy were observed in the upstream of the mass. Histopathologically, the tumor protruded into the downstream edge of the dilatated main pancreatic duct lumen in the pancreatic body. The tumor cells had highly atypical nuclei and abundant polymorphic structures, and showed positive staining for granulocyte colony-stimulating factor, which led to the diagnosis of undifferentiated carcinoma. A total of 13 cases of undifferentiated carcinoma with intraductal tumor growth have been reported to date. The case report by Bergmann et al. has been the smallest in histopathological specimen, and the present case is the smallest in size detected by radiological images. Since early undifferentiated carcinoma of the pancreas can resemble those of main-duct intraductal papillary mucinous neoplasm in cross-sectional images, we have to consider undifferentiated carcinoma in the differential diagnosis of the solitary and papillary mass with low contrast enhancement in early phase in the main pancreatic duct.
- DXA Variations and Fractures After Simultaneous Pancreas-Renal Transplantation: Results of a Long-Term Follow-up. [JOURNAL ARTICLE]
- Clin Nucl Med 2014 Dec 18.
Simultaneous pancreas-kidney transplant (SPKT) has been associated with an increased risk of fracture. We prospectively evaluated the long-term effects of SPKT on bone mineral density (BMD) and fracture risk. During 1998 to 1999, 29 participants were consecutively monitored, and 18 completed the 10-year follow-up. Laboratory blood parameters, lumbar-dorsal radiography, and DEXA were determined at baseline, 1 year, and 10 years. The medical record was reviewed for peripheral fragility fractures. The BMD revealed no changes between baseline and 1 or 10 years after SPKT. Lumbar-dorsal radiography showed 0% asymptomatic vertebral fractures at baseline and after 1 year with 16.7% at 10 years. Vertebral asymptomatic fractures were correlated with acute rejection episodes (P = 0.025). During the first year, no nonvertebral fractures were identified. At the end of the follow-up, 5 nonvertebral fractures in 4 patients were reported. Dorsal and lumbar spine fractures correlated with lumbar spine t score (r = -0.591, P =0.022) and peripheral fractures with femoral neck t score (r = -0.633, P = 0.013). Patients with SPKT did not show long-term significant loss of BMD. The incidence of vertebral fractures was low and related to steroid treatment; the incidence of peripheral fractures was higher and independent of clinical or biochemical parameters.
- Best of the Radiosurgery Society(®) Scientific Meeting 2014: stereotactic radiosurgery/stereotactic body radiotherapy treatment of extracranial and intracranial lesions. [Journal Article]
- Future Oncol 2014 Dec; 10(15):2307-10.
The SRS/SBRT Scientific Meeting 2014, Minneapolis, MN, USA, 7-10 May 2014 The Radiosurgery Society(®), a professional medical society dedicated to advancing the field of stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT), held the international Radiosurgery Society Scientific Meeting, from 7-10 May 2014 in Minneapolis (MN, USA). This year's conference attracted over 400 attendants from around the world and featured over 100 presentations (46 oral) describing the role of SRS/SBRT for the treatment of intracranial and extracranial malignant and nonmalignant lesions. This article summarizes the meeting highlights for SRS/SBRT treatments, both intracranial and extracranial, in a concise review.
- Pancreatic mass leading to left-sided portal hypertension, causing bleeding from isolated gastric varices. [Journal Article]
- Case Rep Gastrointest Med 2014.:956490.
Mucinous cystic neoplasms (MCN) are an uncommon form of exocrine neoplasms of the pancreas. Symptoms are most often vague and this makes the diagnosis more difficult. The current case is one of three cases yet reported where the MCN caused left-sided portal hypertension leading to the formation of isolated gastric varices and subsequent bleeding from the varices. In the previously reported cases the main symptom was hematemesis. However in the current case the patient experienced no hematemesis, only isolated incidents of dark coloured diarrhea, but the main symptoms were those of iron-deficiency anemia. We present the case report of a 34-year-old woman who presented with dizziness and lethargy and was found to have 12 cm MCN in the pancreas.
- Role of CD103 in the development of autoimmune diabetes in NOD mice. [JOURNAL ARTICLE]
- J Endocrinol 2014 Dec 18.
There is compelling evidence that autoreactive CD8+ T cells play a central role in precipitating the development of autoimmune diabetes in NOD mice, but the underlying mechanisms remain unclear. Given that CD103 recognizes an islet-restricted ligand (E-cadherin), we postulated that its expression is required for initiation of disease. We herein use a mouse model of autoimmune diabetes (NOD/ShiLt mice) to test this hypothesis. We show that CD103 is expressed by a discrete subset of CD8+ T cells that infiltrate pancreatic islets prior to the development of diabetes. Moreover, we demonstrate that diabetes development in CD103 deficient NODs is significantly delayed at early but not late time points suggesting that CD103 is preferentially involved in early diabetes development. To rule out a potential contribution by closely linked loci to this delay, we treated wild type NODs beginning at 2weeks of age, through 5 weeks of age with a depleting anti-CD103 mAb and found a decreased incidence of diabetes following anti-CD103 mAb treatment compared to isotype control mAbs or non-depleting mAb to CD103. Moreover, a histologic examination of the pancreas of treated mice revealed that NOD mice treated with a depleting mAb were resistant to immune destruction. These data indicate that CD103+ cells play a key role in the development of autoimmune diabetes, and are consistent with the hypothesis that CD103+CD8+ T effectors initiate the disease process.
- Equine pancreatic disease: A review and characterization of the lesions of four cases (2005-2014). [Journal Article]
- J Vet Diagn Invest 2015 Jan; 27(1):92-6.
Equine pancreatic disease is considered rare, and successful treatment is limited. Additionally, antemortem diagnosis of equine pancreatitis is difficult because of the lack of definitive diagnostic tests. Although a paucity of information exists on this entity in the horse, pancreatic disease has typically been shown to be secondary to other gastrointestinal, hepatic, and endocrine conditions. No predisposition based on age, sex, or breed appears to exist, but several conditions predispose a horse to pancreatitis, including grain overload, endocrine disease, and parasite migration. A retrospective search of cases within the archive of the University of Tennessee necropsy database revealed only 4 cases during a 9-year period (2005-2014). In only 1 case was pancreatic disease considered primary, and in the other 3, pathologies often seen concurrently with pancreatic lesions were identified. These included cecal rupture, colonic displacement, neoplasia (lymphocytic leukemia), and pituitary adenoma. A review of available historical data and associated laboratory results are included with the gross and histologic characteristics of pancreatic lesions, in these 4 newly reported cases.
- Combining conventional and stroma-derived tumour markers in pancreatic ductal adenocarcinoma. [Journal Article]
- Cancer Biomark 2015 Jan 1; 15(1):1-10.
A lack of disease-specific symptoms and good tumour markers makes early detection and diagnosis of pancreatic ductal adenocarcinoma (PDAC) challenging.To analyse the tissue expression and circulating levels of four stroma-derived substances (type IV collagen, endostatin/type XVIII collagen, osteopontin and tenascin C) and four conventional tumour markers (CA 19-9, TPS, CEA and Ca 125) in a PDAC cohort.Tissue expression of markers in normal pancreas and PDAC tissue was analysed with immunofluorescence. Plasma concentrations of markers were measured before and after surgery. Patients with non-malignant disorders served as controls.The conventional and stromal substances were expressed in the cancer cell compartment and the stroma, respectively. Although most patients had increased levels of many markers before surgery, 2/12 (17%) of patients had normal levels of Ca 19-9 at this stage. High preoperative endostatin/type XVIII collagen, and postoperative type IV collagen was associated with short survival. Neither the pre- nor postoperative levels of TPS, Ca 125 or CA 19-9 were associated to survival.PDAC is characterized by an abundant stroma. These initial observations indicate that the stroma can be a source of PDAC tumour markers that are found in different compartments of the cancer, thus reflecting different aspects of tumour biology.