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[PMID]:29428044
[Au] Autor:Ohtsuka T; Mori Y; Fujimoto T; Miyasaka Y; Nakata K; Ohuchida K; Nagai E; Oda Y; Shimizu S; Nakamura M
[Ti] Título:Feasibility of Prophylactic Pancreatojejunostomy in Possible High-Risk Patients for Prevention of Pancreatic Fistula during Enucleation or Limited Pancreatic Resection.
[So] Source:Am Surg;84(1):149-153, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to assess the feasibility of prophylactic pancreatojejunostomy after enucleation or limited pancreatic resection regarding the risk of postoperative pancreatic fistula (PF). We retrospectively reviewed the medical records of 32 patients who underwent enucleation or limited pancreatic resection and compared the clinical parameters between patients with (n = 10) and without (n = 22) prophylactic pancreatojejunostomy. Prophylactic pancreatojejunostomy was performed in patients with a possible high risk ofPF. No operation-related mortality occurred. Operation time was significantly longer (P < 0.01) and blood loss significantly greater (P < 0.01) in patients with pancreatojejunostomy. Overall complications were more frequent (P = 0.02) and postoperative hospital stay was significantly longer (P = 0.02) in patients with pancreatojejunostomy. However, other assessed factors including the prevalence of postoperative PF did not differ between groups. In conclusion, prophylactic pancreatojejunostomy is feasible, and its efficacy in preventing PF after enucleation or limited pancreatic resection in high-risk patients will require further study.
[Mh] Termos MeSH primário: Laparoscopia
Pancreatopatias/cirurgia
Fístula Pancreática/prevenção & controle
Pancreaticojejunostomia
[Mh] Termos MeSH secundário: Adulto
Idoso
Estudos de Viabilidade
Feminino
Seres Humanos
Masculino
Meia-Idade
Pancreatopatias/patologia
Pancreaticojejunostomia/métodos
Reprodutibilidade dos Testes
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180212
[St] Status:MEDLINE


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[PMID]:29309562
[Au] Autor:Rashid CS; Lien YC; Bansal A; Jaeckle-Santos LJ; Li C; Won KJ; Simmons RA
[Ad] Endereço:Center for Research on Reproduction and Women's Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
[Ti] Título:Transcriptomic Analysis Reveals Novel Mechanisms Mediating Islet Dysfunction in the Intrauterine Growth-Restricted Rat.
[So] Source:Endocrinology;159(2):1035-1049, 2018 02 01.
[Is] ISSN:1945-7170
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intrauterine growth restriction (IUGR) increases the risk of type 2 diabetes developing in adulthood. In previous studies that used bilateral uterine artery ligation in a rat model of IUGR, age-associated decline in glucose homeostasis and islet function was revealed. To elucidate mechanisms contributing to IUGR pathogenesis, the islet transcriptome was sequenced from 2-week-old rats, when in vivo glucose tolerance is mildly impaired, and at 10 weeks of age, when rats are hyperglycemic and have reduced ß-cell mass. RNA sequencing and functional annotation with Ingenuity Pathway Analysis revealed temporal changes in IUGR islets. For instance, gene expression involving amino acid metabolism was significantly reduced primarily at 2 weeks of age, but ion channel expression, specifically that involved in cell-volume regulation, was more disrupted in adult IUGR islets. Additionally, we observed alterations in the microenvironment of IUGR islets with extracellular matrix genes being significantly increased at 2 weeks of age and significantly decreased at 10 weeks. Specifically, hyaluronan synthase 2 expression and hyaluronan staining were increased in IUGR islets at 2 weeks of age (P < 0.05). Mesenchymal stromal cell-derived factors that have been shown to preserve islet allograft function, such as Anxa1, Cxcl12, and others, also were increased at 2 weeks and decreased in adult islets. Finally, comparisons of differentially expressed genes with those of type 2 diabetic human islets support a role for these pathways in human patients with diabetes. Together, these data point to new mechanisms in the pathogenesis of IUGR-mediated islet dysfunction in type 2 diabetes.
[Mh] Termos MeSH primário: Diabetes Mellitus Tipo 2/etiologia
Retardo do Crescimento Fetal/genética
Retardo do Crescimento Fetal/metabolismo
Ilhotas Pancreáticas/fisiopatologia
Pancreatopatias/etiologia
Transcriptoma
[Mh] Termos MeSH secundário: Animais
Células Cultivadas
Feminino
Retardo do Crescimento Fetal/fisiopatologia
Perfilação da Expressão Gênica
Seres Humanos
Pancreatopatias/genética
Pancreatopatias/fisiopatologia
Gravidez
Efeitos Tardios da Exposição Pré-Natal/genética
Efeitos Tardios da Exposição Pré-Natal/metabolismo
Efeitos Tardios da Exposição Pré-Natal/fisiopatologia
Ratos
Ratos Sprague-Dawley
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180109
[St] Status:MEDLINE
[do] DOI:10.1210/en.2017-00888


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[PMID]:29381957
[Au] Autor:Ma A; Liu H
[Ad] Endereço:Peking Union Medical College Hospital, No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, China.
[Ti] Título:Ectopic thyroid of the pancreas: A case report and literature review.
[So] Source:Medicine (Baltimore);96(47):e8707, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Ectopic thyroid is commonly found in the neck region. Intra-abdominal ectopic thyroid is extremely rare, with only 2 cases reported in the pancreatic region. Very few reports have described detailed imaging findings of intra-abdominal ectopic thyroid. PATIENT CONCERNS: A 73-year-old woman with aggravated recurrent right upper quadrant pain was found to have a retroperitoneal mass at the head of pancreas. Abdominal computed tomography (CT) showed a well-defined, high attenuated (56HU) mass measured of 60 × 50 mm in diameter, that exhibited heterogeneous contrast enhancement throughout the 3 phases. DIAGNOSIS: Neuroendocrine neoplasm was suspected. INTERVENTIONS: Following discussions with the patient, she refused fine needle aspiration cytology; however, she underwent total resection of the mass and had an uneventful clinical course. Histopathological examination showed thyroid tissue with TTF-1 and TGB positivity, and BRAF negativity, indicating a benign variant. OUTCOMES: The patient had no signs of relapse with normal thyroid hormone levels after 2 years of follow up. LESSONS: Ectopic thyroid tissue should be considered when patients present with similar imaging findings in abdomen. We review all reported cases of abdominal ectopic thyroid tissue to provide specific evidence for the diagnosis and treatment of this rare entity.
[Mh] Termos MeSH primário: Pancreatopatias/patologia
Disgenesia da Tireoide/patologia
[Mh] Termos MeSH secundário: Idoso
Biópsia por Agulha Fina
Diagnóstico Diferencial
Feminino
Seres Humanos
Pancreatopatias/diagnóstico
Pancreatopatias/cirurgia
Disgenesia da Tireoide/diagnóstico
Disgenesia da Tireoide/cirurgia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008707


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[PMID]:29384897
[Au] Autor:Yang B; Valluru B; Guo YR; Cui C; Zhang P; Duan W
[Ad] Endereço:Department of Radiology.
[Ti] Título:Significance of imaging findings in the diagnosis of heterotopic spleen-an intrapancreatic accessory spleen (IPAS): Case report.
[So] Source:Medicine (Baltimore);96(52):e9040, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Accessory spleen (Heterotopic/Ectopic) or splenunculus has been attributed to the failure of the fusion of splenic primordial buds-derived from dorsal mesentery (mesodermal mesenchymal in origin) during the 5th week of embryonic organogenesis or to an extreme degree of splenic lobulation with pinching off of the spleen tissue. The most common locations for accessory spleens are the hilum of the spleen followed by adjacent to the tail of the pancreas. The patients usually present with no clinical symptoms. PATIENT CONCERNS: A 49-year-old female undergoing a routine medical examination- Abdominal Ultrasound revealed a pancreatic mass. She was admitted into the hospital for 3 days and was put under observation. There are no specific findings during the physical examination or any related abnormalities in the laboratory investigations. DIAGNOSIS: Heterotopic spleen-an intrapancreatic accessory spleen (IPAS). INTERVENTIONS: Noncontrast CT of the abdomen demonstrated a soft tissue mass with a clear boundary in the tail of the pancreas. On contrast examination-the arterial phase, it was markedly enhanced, homogenous congruity similar to that of spleen; on magnetic resonance imaging (MRI)-T2WI with fat suppressed sequence, it demonstrated a regular round clear edged mass in the pancreatic tail. On Diffusion Weighted Imaging (DWI), a mass with a clear boundary was observed within the parenchyma of the pancreatic tail. The mass showed a high signal on noncontrast MRI, while on contrast examination, the mass showed a strengthening signal with homogenous enhancement as that of spleen. OUTCOMES: Heterotopic spleen presentation is a very rare asymptomatic clinical condition. During the routine medical examination - it presents mostly as a solitary benign round or oval mass with a clear boundary or as an ectopic focus, either in the pancreatic tail or adjacent to the pancreatic appendage, as an incidental finding. On Contrast CT, it shows as a homogeneously enhanced density- a strengthening mass lesion, in the pancreatic tail, similar to that of spleen. LESSONS: Our case emphasizes the importance of recognizing IPAS radiological characteristics and typical variations in its presentation in an asymptomatic patient that could help the personnel to differentiate it from other mass lesions. Thus, recognizing imaging findings on Plain CT, Contrast CT and MRI plays a key role to form a conclusive diagnosis of an accessory spleen, which has to be clinically associated. So, surgeons should consider IPAS as a differential for which unnecessary resection and an unintended surgical procedure can be avoided.
[Mh] Termos MeSH primário: Coristoma/diagnóstico por imagem
Pancreatopatias/diagnóstico por imagem
Baço
[Mh] Termos MeSH secundário: Coristoma/patologia
Coristoma/cirurgia
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Meia-Idade
Pancreatopatias/patologia
Pancreatopatias/cirurgia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009040


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[PMID]:29178640
[Au] Autor:Sukalo M; Schäflein E; Schanze I; Everman DB; Rezaei N; Argente J; Lorda-Sanchez I; Deshpande C; Takahashi T; Kleger A; Zenker M
[Ad] Endereço:Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany.
[Ti] Título:Expanding the mutational spectrum in Johanson-Blizzard syndrome: identification of whole exon deletions and duplications in the UBR1 gene by multiplex ligation-dependent probe amplification analysis.
[So] Source:Mol Genet Genomic Med;5(6):774-780, 2017 11.
[Is] ISSN:2324-9269
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Johanson-Blizzard syndrome (JBS, MIM #243800) is a very rare autosomal recessive disorder characterized by exocrine pancreatic insufficiency, nasal wing hypoplasia, hypodontia, and other abnormalities. JBS is caused by mutations of the UBR1 gene (MIM *605981), encoding a ubiquitin ligase of the N-end rule pathway. METHODS: Molecular findings in a total of 65 unrelated patients with a clinical diagnosis of JBS who were previously screened for UBR1 mutations by Sanger sequencing were reviewed and cases lacking a disease-causing UBR1 mutation on either one or both alleles were included in this study. In order to discover mutations that are not detectable by Sanger sequencing, we designed a probe set for multiplex ligation-dependent probe amplification (MLPA) analysis of the UBR1 gene and analyzed the copy number status of all 47 UBR1 exons. RESULTS: Our previous studies using Sanger sequencing could detect mutations in 93.1% of 130 disease-associated UBR1 alleles. Six patients with a highly suggestive clinical diagnosis of JBS and unsolved genotype were included in this study. MLPA analysis detected six alleles harboring exon deletions/duplications, thereby raising the mutation detection rate in the entire cohort to 97.7% (127/130 alleles). CONCLUSION: We conclude that single or multi-exon deletions or duplications account for a substantial proportion of JBS-associated UBR1 mutations.
[Mh] Termos MeSH primário: Anus Imperfurado/genética
Displasia Ectodérmica/genética
Transtornos do Crescimento/genética
Perda Auditiva Neurossensorial/genética
Hipotireoidismo/genética
Deficiência Intelectual/genética
Nariz/anormalidades
Pancreatopatias/genética
Ubiquitina-Proteína Ligases/genética
[Mh] Termos MeSH secundário: Adulto
Alelos
Anus Imperfurado/diagnóstico
Sequência de Bases
Criança
Pré-Escolar
DNA/química
DNA/isolamento & purificação
DNA/metabolismo
Análise Mutacional de DNA
Displasia Ectodérmica/diagnóstico
Éxons
Feminino
Deleção de Genes
Duplicação Gênica
Genótipo
Transtornos do Crescimento/diagnóstico
Perda Auditiva Neurossensorial/diagnóstico
Seres Humanos
Hipotireoidismo/diagnóstico
Deficiência Intelectual/diagnóstico
Masculino
Reação em Cadeia da Polimerase Multiplex
Pancreatopatias/diagnóstico
Fenótipo
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
9007-49-2 (DNA); EC 2.3.2.27 (UBR1 protein, human); EC 2.3.2.27 (Ubiquitin-Protein Ligases)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1002/mgg3.319


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[PMID]:29019877
[Au] Autor:Shan GD; Chen WG; Hu FL; Chen LH; Yu JH; Zhu HT; Gao QQ; Xu GQ
[Ad] Endereço:aDepartment of Gastroenterology bDepartment of Pathology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
[Ti] Título:A spontaneous hematoma arising within an intrapancreatic accessory spleen: A case report and literature review.
[So] Source:Medicine (Baltimore);96(41):e8092, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONAL: Hematoma arising within an intrapancreatic accessory spleen (IPAS) is an extremely rare pathological entity. PATIENT CONCERN: We present the case of a 39-year-old man with acute abdominal pain. DIAGNOSES: The patient was initially diagnosed as pancreatic cystic neoplasm according to CT and MRI imaging. INTERVENTIONS: Distal pancreatectomy was conducted because of the possibility of malignancy. OUTCOMES: Surgical resection showed that the lesion was a hematoma in an IPAS. LESSONS: Our case indicated that the differential diagnosis of hematoma in IPAS should be born in mind for cases with cystic neoplasm in tail of pancreas and an epidermoid cyst arising within an intrapancreatic accessory spleen (ECIAS).
[Mh] Termos MeSH primário: Abdome Agudo
Hematoma
Pâncreas
Pancreatectomia/métodos
Pancreatopatias
Neoplasias Pancreáticas/diagnóstico
Baço
[Mh] Termos MeSH secundário: Abdome Agudo/diagnóstico
Adulto
Diagnóstico Diferencial
Hematoma/complicações
Hematoma/diagnóstico
Hematoma/fisiopatologia
Hematoma/cirurgia
Seres Humanos
Masculino
Pâncreas/diagnóstico por imagem
Pâncreas/patologia
Pancreatopatias/diagnóstico
Pancreatopatias/fisiopatologia
Pancreatopatias/cirurgia
Baço/anormalidades
Baço/diagnóstico por imagem
Baço/lesões
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008092


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[PMID]:28979631
[Au] Autor:Bakkaly AE; Merouane N; Dalero O; Oubeja H; Erraji M; Ettayebi F; Zerhouni H
[Ad] Endereço:Pediatric Surgical Emergency Department, Children's Hospital, University Hospital of Ibn Sina, Faculty of Medicine Mohammed V, BP 6527, Street of Lamfadel Cherkaoui Rabat Institut, Rabat, Morocco.
[Ti] Título:Primary hydatid cyst of the pancreas of the child: a case report.
[So] Source:Pan Afr Med J;27:229, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:Primary pancreatic hydatid lesions are very rare with an incidence of less than 1% in the adult population. We report an observation of a 5-year-old girl who consulted for isolated abdominal pain occurring for 2 weeks without vomiting, transit disorders or jaundice and evolving in a context of conservation of the general condition and apyrexia. Clinical examination and preoperative imaging have suggested the diagnosis of a choledochal cyst or duodenal duplication rather than a hydatid cyst of the pancreas due to the presence of a cystic hepatic image projecting into the liver hilum. During the procedure, a hydatid cyst was found occupying the head of the pancreas. Primary hydatidosis of the pancreas in children is extremely rare. Possible sources of infection include: blood diffusion, local spread via biliopancreatic ducts and peripancreatic lymphatic invasion. In the endemic areas, hydatid disease should be mentioned in the list of differential diagnoses of cystic lesions located around the biliopancreatic junction in children.
[Mh] Termos MeSH primário: Dor Abdominal/etiologia
Cisto do Colédoco/diagnóstico
Equinococose/diagnóstico
Pancreatopatias/diagnóstico
[Mh] Termos MeSH secundário: Dor Abdominal/parasitologia
Pré-Escolar
Diagnóstico Diferencial
Equinococose/parasitologia
Feminino
Seres Humanos
Pâncreas/parasitologia
Pancreatopatias/parasitologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171006
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.229.12853


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[PMID]:28906401
[Au] Autor:Li S; Su L; Lv G; Zhao W; Chen J
[Ad] Endereço:Department of Ultrasonography, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
[Ti] Título:Transabdominal ultrasonography of the pancreas is superior to that of the liver for detection of ectopic fat deposits resulting from metabolic syndrome.
[So] Source:Medicine (Baltimore);96(37):e8060, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of our study was to investigate the rate of nonalcoholic fatty pancreas disease (NAFPD) in the south China province of Fujian and its relationship to nonalcoholic fatty liver disease (NAFLD) and metabolic parameters.NAFPD is frequently identified on transabdominal ultrasound examination. The incidence of NAFPD varies from 16% to 69.7% depending on the country.A total of 256 subjects were recruited. Each was assessed by abdominal sonography to diagnose NAFLD and NAFPD. The ages, sexes, heights, weights, blood pressure, and detection of peripheral blood biochemical indices (cholesterol, triglycerides, high-density lipoprotein cholesterol [HDL], low-density lipoprotein cholesterol [LDL], and glucose) were recorded. The relationships among metabolic parameters and NAFPD or NAFLD were evaluated, and the positive rates of NAFLD and NAFPD in the general population were compared.The age, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), cholesterol, triglycerides, HDL, LDL, and glucose were significantly associated with NAFPD and NAFLD but the positive rate of NAFPD was significantly higher than that of NAFLD. The BMI, age, and NAFLD were the independent risk factors of NAFPD. The sex distribution, weight, SBP, DBP, BMI, LDL, HDL, triglycerides, glucose, cholesterol, NAFPD, and NAFLD were different significantly between metabolic syndrome and normal subjects.NAFPD and NAFLD can reflect the body metabolism, but NAFPD has a higher detection rate.
[Mh] Termos MeSH primário: Fígado/diagnóstico por imagem
Síndrome Metabólica/diagnóstico por imagem
Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem
Pâncreas/diagnóstico por imagem
Pancreatopatias/diagnóstico por imagem
Ultrassonografia
[Mh] Termos MeSH secundário: Biomarcadores/sangue
China
Feminino
Seres Humanos
Incidência
Lipídeos/sangue
Modelos Logísticos
Masculino
Síndrome Metabólica/complicações
Síndrome Metabólica/epidemiologia
Meia-Idade
Análise Multivariada
Hepatopatia Gordurosa não Alcoólica/epidemiologia
Hepatopatia Gordurosa não Alcoólica/etiologia
Pancreatopatias/epidemiologia
Pancreatopatias/etiologia
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Lipids)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008060


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[PMID]:28834874
[Au] Autor:Huh CW; Kim HW; Yi SW; Lee DK; Lee SJ
[Ad] Endereço:aDivision of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary's Hospital, the Catholic University of Korea, Incheon bDepartment of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
[Ti] Título:Common bile duct stones associated with pancreatobiliary reflux and disproportionate bile duct dilatation.
[So] Source:Medicine (Baltimore);96(34):e7701, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Occult pancreatobiliary reflux (PBR) in patients with a normal pancreatobiliary junction has been studied by various methods, but the exact etiology, mechanisms, and implications of this reflux have not yet been clarified. The aim of this study was to investigate the degree of PBR and patterns of biliary ductal dilatation in patients with acute calculous cholangitis by endoscopic retrograde cholangiopancreatography (ERCP).We retrospectively evaluated the degree of PBR and pattern of bile duct dilatation in patients with acute calculous cholangitis due to distal CBD (common bile duct) stones (Group A) as compared with patients with malignant CBD obstruction due to distal CBD cancer (Group B). All related data were prospectively collected. Bile juice was aspirated at the proximal CBD for measurement of biliary amylase and lipase before the injection of contrast dye. The diameters of the CBD and the peripheral intrahepatic duct (IHD) were calculated after contrast dye injection. Patients with pancreatobiliary maljunction and/or gallstone pancreatitis were excluded from the study.ERCP was performed on 33 patients with calculous cholangitis (Group A) and 12 patients with malignant CBD obstruction (Group B). Mean levels of bile amylase and lipase were significantly higher (P < .05) in group A (1387 and 6737 U/l, respectively) versus those in group B (32 and 138 U/l, respectively). Thirty patients in group A (90.9%) showed disproportionate dilatation (i.e., CBD was and IHD was not dilated), whereas only 4 patients in group B (33%) showed disproportionate dilatation.The results of this study suggest that patients with calculous cholangitis exhibit PBR that is associated with disproportionate bile duct dilatation.
[Mh] Termos MeSH primário: Cálculos Biliares/epidemiologia
Pancreatopatias/epidemiologia
Pancreatopatias/patologia
Ductos Pancreáticos/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Ácidos e Sais Biliares/análise
Colangiopancreatografia Retrógrada Endoscópica
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Bile Acids and Salts)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007701


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[PMID]:28811674
[Au] Autor:Ellis C; Ramzy A; Kieffer TJ
[Ad] Endereço:Laboratory of Molecular and Cellular Medicine, Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada.
[Ti] Título:Regenerative medicine and cell-based approaches to restore pancreatic function.
[So] Source:Nat Rev Gastroenterol Hepatol;14(10):612-628, 2017 Oct.
[Is] ISSN:1759-5053
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The pancreas is a complex organ with exocrine and endocrine components. Many pathologies impair exocrine function, including chronic pancreatitis, cystic fibrosis and pancreatic ductal adenocarcinoma. Conversely, when the endocrine pancreas fails to secrete sufficient insulin, patients develop diabetes mellitus. Pathology in either the endocrine or exocrine pancreas results in devastating economic and personal consequences. The current standard therapy for treating patients with type 1 diabetes mellitus is daily exogenous insulin injections, but cell sources of insulin provide superior glycaemic regulation and research is now focused on the goal of regenerating or replacing ß cells. Stem-cell-based models might be useful to study exocrine pancreatic disorders, and mesenchymal stem cells or secreted factors might delay disease progression. Although the standards that bioengineered cells must meet before being considered as a viable therapy are not yet established, any potential therapy must be acceptably safe and functionally superior to current therapies. Here, we describe progress and challenges in cell-based methods to restore pancreatic function, with a focus on optimizing the site for cell delivery and decreasing requirements for immunosuppression through encapsulation. We also discuss the tools and strategies being used to generate exocrine pancreas and insulin-producing ß-cell surrogates in situ and highlight obstacles to clinical application.
[Mh] Termos MeSH primário: Terapia Baseada em Transplante de Células e Tecidos/métodos
Técnicas de Reprogramação Celular
Pancreatopatias/fisiopatologia
Pancreatopatias/terapia
Medicina Regenerativa
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170817
[St] Status:MEDLINE
[do] DOI:10.1038/nrgastro.2017.93



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