- Effects of Lactobacillus plantarum CCFM0236 on Hyperglycemia and Insulin Resisitance in High-fat and Streptozotocin Induced Type 2 Diabetic Mice. [JOURNAL ARTICLE]
- J Appl Microbiol 2016 Aug 23.
The aim of this study was to rapidly screen potential hypoglycemic strain by α-glucosidase inhibitory activity in vitro, then explored the antidiabetic effect of L. plantarum CCFM0236 in vivo.The cell-free supernatant of L. plantarum CCFM0236 significantly inhibited α-glucosidase activity in vitro. Therefore, the effects of L. plantarum CCFM0236 with potential hypoglycemia activity on insulin resistance and hyperglycemia were explored in high-fat and streptozotocin induced type 2 diabetes mice. Oral administration of L. plantarum CCFM0236 were found to decrease food intake, blood glucose level, glycosylated hemoglobin level, and leptin level. Treatments of L. plantarum CCFM0236 also favorably regulated insulin level, AUCglucose , and HOMA-IR index, and increased the activities of glutathione peroxidase and the levels of glutathione, high-density lipoprotein cholesterol, and interleukin-10. In addition, L. plantarum CCFM0236 reduced levels of malondialdehyde and tumor necrosis factor-α and protected pancreas function.L. plantarum CCFM0236 has potential hypoglycemic ability by ameliorating insulin resistance, antioxidant capacity and systemic inflammation in mice.The method of α-glucosidase inhibitory activity could be effectively used to screen potential hypoglycemic products and L. plantarum CCFM0236 might be a promising therapeutic agent for ameliorating type 2 diabetes. This article is protected by copyright. All rights reserved.
- Primary hydatid cyst of pancreas: Case report and review of literature. [JOURNAL ARTICLE]
- Int J Surg Case Rep 2016 Aug 2.:74-77.
Hydatid disease is caused by the larval stage of Echinococcus granulosus. It most commonly affects the liver and lung. Pancreatic hydatid cyst (PHC) is very rare with incidence of 0.14%-2%.A 40year old lady presented with epigastric pain for last 3 months. A 5×5cm abdominal lump occupying the epigastric and left hypochondrial region was noted on physical examination. Ultrasonography (USG) and Contrast enhanced Computed Tomogrpahy (CT) revealed a 55×57mm cystic structure in the pancreatic body. Endoscopic ultrasound guided fluid aspiration cytology revealed normal Carcinoembryonic antigen and Amylase levels. Cytological examination was noncontributory. During open surgical exploration, it was found to be a hydatid cyst. After irrigation with scolicidal agent and evacuation of cystic contents, Partial cystectomy with external drainage was done. Histopathological biopsy revealed Hydatid cyst. Post-operative ELISA (Enzyme linked immunosorbent assay) for Echinococcal antigen was positive.PHC is a rare entity. Most common mode of spread is hematogenous. Cysts in pancreatic head can present as obstructive jaundice. Cysts in body and tail are usually asymptomatic. USG, CT and Hydaitd serology can help in diagnosis and monitoring recurrence. Surgical exploration is treatment of choice. Options include pericystectomy, partial cystectomy+/- external drainage/omentopexy, marsupialization or cysto-enterostomy. Preoperative and Post-operative anti helminthic (Albendazole) is recommended.PHC can masquerade as pseudocyst or cystic neoplasm of pancreas. It should always be considered in the differential diagnosis of cystic pancreatic lesion in patients from endemic regions.
- More deaths from pancreatic cancer than breast cancer in the EU by 2017. [JOURNAL ARTICLE]
- Acta Oncol 2016 Aug 23.:1-3.
Pancreatic cancer currently ranks below female breast cancer in terms of the number of deaths in both males and females in the EU. While breast cancer mortality rates have been declining in many higher income EU countries during recent decades, rates of pancreatic cancer in contrast are either stable or moderately increasing; a comparative analysis of the short-term future rates of both is warranted.We extracted the annual number of deaths from cancers of the pancreas and breast by gender together with population at risk in each of 28 countries of the EU for the period 2001-2010. We fitted cancer- and gender-specific time-linear regression models and predicted deaths from pancreatic and breast cancer mortality for the years 2011-2025.We estimated that by the year 2017 more deaths from pancreatic cancer will occur (91 500 annual deaths) than breast cancer (91 000) in the EU. By 2025, deaths from cancer of the pancreas are predicted to be 25% higher (111 500 and 90 000, respectively). Pancreatic cancer may become the third leading cause of death from cancer in the EU after lung and colorectal cancers.Although strategies may emerge in the near future that will enhance the prospects of improving the very poor five-year survival from pancreatic cancer, coordinated efforts are necessary to reduce the foreseeable high mortality burden of disease within the EU.
- MUC4 is negatively regulated through the Wnt/β-catenin pathway via the Notch effector Hath1 in colorectal cancer. [Journal Article]
- Genes Cancer 2016 May; 7(5-6):154-68.
MUC4 is a transmembrane mucin lining the normal colonic epithelium. The aberrant/de novo over-expression of MUC4 is well documented in malignancies of the pancreas, ovary and breast. However, studies have reported the loss of MUC4 expression in the majority of colorectal cancers (CRCs). A MUC4 promoter analysis showed the presence of three putative TCF/LEF sites, implying a possible regulation by the Wnt/β-catenin pathway, which has been shown to drive CRC progression. Thus, the objective of our study was to determine whether MUC4 is regulated by β-catenin in CRC. We first knocked down (KD) β-catenin in three CRC cell lines; LS180, HCT-8 and HCT116, which resulted in increased MUC4 transcript and MUC4 protein. Additionally, the overexpression of stabilized mutant β-catenin in LS180 and HCT-8 resulted in a decrease in MUC4 expression. Immunohistochemistry (IHC) of mouse colon tissue harboring tubular adenomas and high grade dysplasia showed dramatically reduced Muc4 in lesions relative to adjacent normal tissue, with increased cytosolic/nuclear β-catenin. Luciferase assays with the complete MUC4 promoter construct p3778 showed increased MUC4 promoter luciferase activity in the absence of β-catenin (KD). Mutation of all three putative TCF/LEF sites showed that MUC4 promoter luciferase activity was increased relative to the un-mutated promoter. Interestingly, it was observed that MUC4 expressing CRC cell lines also expressed high levels of Hath1, a transcription factor repressed by both active Wnt/β-catenin and Notch signaling. The KD of β-catenin and/or treatment with a Notch γ-secretase inhibitor, Dibenzazepine (DBZ) resulted in increased Hath1 and MUC4 in LS180, HCT-8 and HCT116. Furthermore, overexpression of Hath1 in HCT-8 and LS180 caused increased MUC4 transcript and MUC4 protein. Taken together, our results indicate that the Wnt/β-catenin pathway suppresses the Notch pathway effector Hath1, resulting in reduced MUC4 in CRC.
- Obstructive Jaundice as a Complication of Macrocystic Serous Cystadenoma of the Pancreas. [Journal Article]
- Acta Med Indones 2016 Apr; 48(2):129-33.
Macrocystic serous cystadenoma is an unusual and essentially benign pancreatic tumor. Herein, we report on a 40-year-old woman diagnosed with macrocystic serous cystadenoma who presented with obstructive jaundice. A cystic lesion in the head and body of the pancreas was revealed by abdominal computed tomography. Intraoperative pancreatic cyst aspiration ruled out mucinous cystic neoplasm which has a malignant potential. The pancreatic cyst fluid cytology was basophilic amorph materials concluded as benign cystic lesion. Internal drainage was performed instead of pancreatic resection which showed good outcome. Biliary obstruction is a rare complication of serous cystadenoma. This case describes an unusual clinical presentation of macrocystic serous cystadenoma.
- A Safe Method for Middle Colic Dissection and Ligation at its Origin in a Laparoscopic Extended Right Hemicolectomy. [JOURNAL ARTICLE]
- Ann Surg Oncol 2016 Aug 22.
Laparoscopic extended right hemicolectomy is regarded as one of the more difficult procedures in colorectal surgery due to the complexity of the dissection around the pancreatic neck to identify the origin of the middle colic artery.1 Proper identification and ligation of the middle colic artery at its origin is paramount to achieve complete mesocolic excision.2 (,) 3 We describe our technique of middle colic vessels dissection in a laparoscopic extended right hemicolectomy.Our patient was a 58-year-old female with a stenosing transverse colon adenocarcinoma. The video highlights the key steps of a laparoscopic extended right hemicolectomy with special attention to the dissection and identification of the origin of the middle colic vessels at the pancreatic neck. We utilized a posterior-to-anterior approach for the dissection around the superior mesenteric pedicle.By carefully skeletonizing the pancreas from the body to the neck, the superior mesentery pedicle is isolated and skeletonized to identify the origin of the middle colic vessels. A posterior-to-anterior approach is used to complete the skeletonisation before ligation of the middle colic vessels at its origin. Operative time was 288 min with an estimated blood loss of 40 ml. The patient recovered well without complications of pancreatitis and was discharged on postoperative day 5. Histology revealed a 4-cm moderately differentiated adenocarcinoma with 10 of 34 lymph nodes involved-pT3N2b.With the increasing popularity of laparoscopic surgery, meticulous laparoscopic dissection of the middle colic vessels is feasible and safe and may potentially help to optimize oncological outcomes for laparoscopic extended right hemicolectomy.
- Malignant pancreatic serous cystic neoplasms: systematic review with a new case. [Journal Article]
- BMC Gastroenterol 2016; 16(1):97.
This study analyzes the clinicopathologic and radiologic characteristics of malignant serous cystic neoplasm (SCN) of the pancreas through systematic review and an institutional case report.A comprehensive literature search was performed in the MEDLINE database to identify studies on malignant SCNs of the pancreas that had detailed clinicopathologic and radiologic information. A computerized systematic search of our institutional database was also performed to identify cases of malignant SCN for addition to the systematic review. Using the final included cases, we analyzed the clinicopathologic and radiologic features of malignant SCNs of the pancreas.A review of 136 candidate articles identified 26 studies with 26 cases that had detailed clinical information. Our institutional data search added one case. The systematic review of the 27 cases revealed that primary tumors (mean diameter 10.2 ± 4.0 cm) mainly involved the body and tail of the pancreas (n = 16) and frequently invaded adjacent organs (n = 19). Distant metastases occurred in 14 patients (synchronous, n = 5; metachronous, n = 8; both, n = 1), most commonly in the liver (n = 13). Imaging features of malignant SCNs of the pancreas were identical to the benign counterpart, except local invasion or distant metastases. The prognosis was excellent in that 17 were alive at the time of writing with a median follow-up period of 2 years.The malignant potential of SCNs of the pancreas should be considered in the diagnosis and management of patients with pancreatic SCNs.
- Functional and molecular adaptations of enteroendocrine L-cells in male obese mice are associated with preservation of pancreatic alpha-cells function and prevention of hyperglycemia. [JOURNAL ARTICLE]
- Endocrinology 2016 Aug 22.:en20161433.
Glucose homeostasis depends on the coordinated secretion of glucagon, insulin and GLP-1 by pancreas and intestine. Obesity which is associated with an increased risk of developing insulin resistance and type 2 diabetes affects the function of these organs. Here we investigate the functional and molecular adaptations of proglucagon-producing cells in obese mice to better define their involvement in type 2 diabetes development. We used GLU-Venus transgenic male mice specifically expressing Venus fluorochrome in proglucagon-producing cells. Mice were subjected to 16 weeks of low-fat (LFD) or high-fat (HFD) diets, and then subdivided by measuring glycated haemoglobin (HbA1c) in three groups: LFD mice and I-HFD (glucose-intolerant) mice with similar HbA1c and H-HFD (hyperglycemic) mice which exhibited higher HbA1c. At 16 weeks, both HFD groups exhibited similar weight gain, hyperinsulinemia and insulin resistance. However, I-HFD mice exhibited better glucose tolerance compared to H-HFD mice. I-HFD mice displayed functional and molecular adaptations of enteroendocrine L-cells resulting in increased intestinal GLP-1 biosynthesis and release as well as maintained pancreatic alpha- and beta-cells functions. By contrast, H-HFD mice exhibited dysfunctional L, alpha- and beta-cells with increased beta- and L-cell numbers. Administration of the GLP-1R antagonist Exendin9-39 in I-HFD mice led to hyperglycemia and alterations of glucagon secretion without changes in insulin secretion. Our results highlight the cross-talk between islet and intestine endocrine cells and indicate that a compensatory adaptation of L-cell function in obesity plays an important role in preserving glucose homeostasis through the control of pancreatic alpha-cell functions.
- Dilemmas in autoimmune pancreatitis. Surgical resection or not? [Journal Article]
- Bratisl Lek Listy 2016; 117(8):463-7.
Surgical treatment is not commonly recommended in the management of autoimmune pancreatitis. The article describes a dilemma in diagnostics and treatment of a 68-year old man with the mass in the head of the pancreas that mimicked pancreatic cancer and that was diagnosed as a type 1 autoimmune pancreatitis (IgG4-related pancreatitis) after a surgical resection. Diagnosis of the autoimmune pancreatitis is a real clinical challenge, as in the current diagnostic criteria exists some degree of overlap in the findings between autoimmune pancreatitis and pancreatic cancer (indicated by the similarity in radiologic findings, elevation of IgG4, sampling errors in pancreatic biopsy, and the possibility of synchronous autoimmune pancreatitis and pancreatic cancer). Despite the generally accepted corticosteroids as the primary treatment modality in autoimmune pancreatitis, we believe that surgical resection remains necessary in a specific subgroup of patients with autoimmune pancreatitis (Fig. 4, Ref. 37).