• Title/Summary/Keyword: Cancer, Pancreatic

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Two Cases of Malignancy Diagnosed during the Treatment of Thoracic Postherpetic Neuralgia -A report of two cases- (흉부 대상포진후 신경통 치료 중 발견된 악성 종양 -증례보고-)

  • Lee, Hee-Jeon;Lee, Hyo-Keun;Chung, So-Young;Chae, Jeong-Hye;Kim, Chan
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.135-138
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    • 1995
  • We experienced two cases of malignancy diagnosed during the treatment of postherpetic neuralgia. One case was a lung cancer and the other case was a pancreatic cancer. Generally, herpes zoster frequently occurred in the patients who have immunosupressive disease, diabetes mellitus, malignancy and tuberculosis, etc. It is necessary to rule out malignancy in the patients who have herpes zoster, especially those patients whth severe eruptive cluster, persisting to the therapy or multifocal pain. So, we must carefully observe and follow up the patients to find out malignancy as well as to diminish the pain.

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Endoscopic Management of Ampullary Tumors (십이지장 팽대부 종양의 내시경적 치료)

  • Hwehoon Chung;Jae Keun Park
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.93-98
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    • 2023
  • Ampullary tumor is a rare disease whose prevalence rate has increased gradually in recent years with the increase in endoscopic examinations. Ampullary lesions are observed via endoscopy, and biopsy is done to determine whether such lesions are adenomas or carcinomas. Endoscopic papillectomy is performed on ampullary adenomas without intraductal lesions. Before the procedure, bleeding tendencies and pancreatitis are assessed, and the lesion is resected using a high-frequency wave and a thin wire snare. Thereafter, pancreatic duct stent insertion or clipping of the resection site is performed to prevent postprocedural pancreatitis. Although 47-93% of the patients achieve complete endoscopic papillary resection, the recurrence rate is 5-31%. Hence, regular follow-up via endoscopy is required.

Large Duct Pancreatic Ductal Adenocarcinoma: A Morphological Variant of Pancreatic Ductal Adenocarcinoma With Distinct CT and MRI Characteristics

  • Se Jin Choi;Sung Joo Kim;Dong Wook Kim;Seung Soo Lee;Seung-Mo Hong;Kyung Won Kim;Jin Hee Kim;Hyoung Jung Kim;Jae Ho Byun
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1232-1240
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    • 2023
  • Objective: To investigate the imaging characteristics of large duct pancreatic ductal adenocarcinoma (LD-PDAC) on computed tomography (CT) and magnetic resonance imaging (MRI). Materials and Methods: Thirty-five patients with LD-PDAC (63.2 ± 9.7 years) were retrospectively evaluated. Tumor morphology on CT and MRI (predominantly solid mass vs. solid mass with prominent cysts vs. predominantly cystic mass) was evaluated. Additionally, the visibility, quantity, shape (oval vs. branching vs. irregular), and MRI signal intensity of neoplastic cysts within the LD-PDAC were investigated. The radiological diagnoses rendered for LD-PDAC in radiology reports were reviewed. Results: LD-PDAC was more commonly observed as a solid mass with prominent cysts (45.7% [16/35] on CT and 37.1% [13/35] on MRI) or a predominantly cystic mass (20.0% [7/35] on CT and 40.0% [14/35] on MRI) and less commonly as a predominantly solid mass on CT (34.3% [12/35]) and MRI (22.9% [8/35]). The tumor morphology on imaging was significantly associated with the size of the cancer gland on histopathological examination (P = 0.020 [CT] and 0.013 [MRI]). Neoplastic cysts were visible in 88.6% (31/35) and 91.4% (32/35) of the LD-PDAC cases on CT and MRI, respectively. The cysts appeared as branching (51.6% [16/35] on CT and 59.4% [19/35] on MRI) or oval shapes (45.2% [14/35] on CT and 31.2% [10/35] on MRI) with fluid-like MRI signal intensity. In the radiology reports, 10 LD-PDAC cases (28.6%) were misinterpreted as diseases other than typical PDAC, particularly intraductal papillary mucinous neoplasms. Conclusion: LD-PDAC frequently appears as a solid mass with prominent cysts or as a predominantly cystic mass on CT and MRI. Radiologists should be familiar with the imaging features of LD-PDAC to avoid misdiagnosis.

Role of Endoscopic Ultrasound in Evaluation of Pancreatic Neuroendocrine Tumors - Report of 22 Cases from a Tertiary Center in Iran

  • Haghighi, Shirin;Molaei, Mahsa;Foroughi, Forough;Foroutan, Mojgan;Dabiri, Reza;Habibi, Effat;Alizadeh, Amir Houshang Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4537-4540
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    • 2012
  • Background: The pancreatic neuroendocrine tumor (pNET) is relatively rare and generally felt to follow an indolent course. EUS has an important role in detection of pNET. This is a review of clinical and radiological presentation and pathologic reports of 22 patients with pNET. Patients and methods: In this study we analyzed clinical and radiological presentations and pathologic reports of all relevant cases who were referred to Taleghani hospital for 3 years since 2008. Results: A total of 22 patients 28-74 years old (mean=49) were enrolled between 2008 and 2011. Among the total, 13 (59%) were male, 9 (41%) were female and 16 (72.7%) had functional tumors. The results of CT were negative in 12 (54%) cases but EUS was capable of detecting the lesions in these patients, cysts being found in 4 (19%) patients. Conclusion: EUS is a highly sensitive procedure for the localization of functional pNETs and especially insulinomas. Nonfunctional tumors were detected in more advanced and late stages and cystic lesions were more common in this group.

Apoptosis of Human Islet Cells by Cytokines

  • Kim, Sun-Shin;Kim, Kyoung-Ah;Suk, Kyoung-Ho;Kim, Yun-Hee;Oh, Seung-Hoon;Lee, Moon-Kyu;Kim, Kwang-Won;Lee, Myung-Shik
    • IMMUNE NETWORK
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    • v.12 no.3
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    • pp.113-117
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    • 2012
  • FasL, perforin, $TNF{\alpha}$, IL-1 and NO have been considered as effector molecule(s) leading to ${\beta}$-cell death in autoimmune diabetes. However, the real culprit(s) of ${\beta}$-cell destruction have long been elusive despite intense investigation. Previously we have suggested $IFN{\gamma}/TNF{\alpha}$ synergism as the final effector molecules in autoimmune diabetes of NOD mice. A combination of $IFN{\gamma}$ and $TNF{\alpha}$ but neither cytokine alone, induced classical caspase-dependent apoptosis in murine insulinoma and pancreatic islet cells. $IFN{\gamma}$ treatment conferred susceptibility to $TNF{\alpha}$-induced apoptosis on otherwise resistant murine insulinoma cells by STAT1 activation followed by IRF-1 induction. Here we report that $IFN{\gamma}/TNF{\alpha}$ synergism induces apoptosis of human pancreatic islet cells. We also observed STAT1 activation followed by IRF-1 induction by $IFN{\gamma}$ treatment in human islet cells. Taken together, we suggest that $IFN{\gamma}/TNF{\alpha}$ synergism could be involved in human islet cell death in type 1 diabetes, similar to murine type 1 diabetes.

Co-amplification at Lower Denaturation-temperature PCR Combined with Unlabled-probe High-resolution Melting to Detect KRAS Codon 12 and 13 Mutations in Plasma-circulating DNA of Pancreatic Adenocarcinoma Cases

  • Wu, Jiong;Zhou, Yan;Zhang, Chun-Yan;Song, Bin-Bin;Wang, Bei-Li;Pan, Bai-Shen;Lou, Wen-Hui;Guo, Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10647-10652
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    • 2015
  • Background: The aim of our study was to establish COLD-PCR combined with an unlabeled-probe HRM approach for detecting KRAS codon 12 and 13 mutations in plasma-circulating DNA of pancreatic adenocarcinoma (PA) cases as a novel and effective diagnostic technique. Materials and Methods: We tested the sensitivity and specificity of this approach with dilutions of known mutated cell lines. We screened 36 plasma-circulating DNA samples, 24 from the disease control group and 25 of a healthy group, to be subsequently sequenced to confirm mutations. Simultaneously, we tested the specimens using conventional PCR followed by HRM and then used target-DNA cloning and sequencing for verification. The ROC and respective AUC were calculated for KRAS mutations and/or serum CA 19-9. Results: It was found that the sensitivity of Sanger reached 0.5% with COLD-PCR, whereas that obtained after conventional PCR did 20%; that of COLD-PCR based on unlabeled-probe HRM, 0.1%. KRAS mutations were identified in 26 of 36 PA cases (72.2%), while none were detected in the disease control and/or healthy group. KRAS mutations were identified both in 26 PA tissues and plasma samples. The AUC of COLD-PCR based unlabeled probe HRM turned out to be 0.861, which when combined with CA 19-9 increased to 0.934. Conclusions: It was concluded that COLD-PCR with unlabeled-probe HRM can be a sensitive and accurate screening technique to detect KRAS codon 12 and 13 mutations in plasma-circulating DNA for diagnosing and treating PA.

Gene Expression Altered in Endometrium of Korean Cattle with Endometritis (한우 자궁내막염에서 발현 변화를 보이는 유전자)

  • Kang, Da-Won
    • Reproductive and Developmental Biology
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    • v.31 no.3
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    • pp.207-213
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    • 2007
  • This study was carried out to examine gene expression altered in endometrium of Korean cattle (Hanwoo) with endometritis using microarray. In this study, 4,560 diferentially expressed genes (DEGs) were identified in the endometrium of Hanwoo. Of 4,560 DEGs, 2,026 genes were up-regulated, while 2,536 genes were down-regulated in endometritis. Of them, top 10 regulated genes were listed. Filamin A, pancreatic anionic trypsinogen, Rho GDP dissociation inhibitor alpha, collagen type VI alpha 1, butyrate response factor 2, aggrecanses-2, annexin 14, aminopeptidease A, orphan transporter v7-3, and epithelial stromal interaction 1 were up-regulated, while MHC class II antigen, integrin-binding sialoprotein, uterine milk protein precursor, down-regulated in colon cancer 1, glycoprotein 330, dickkopf-1, cfh protein, $Ca^{2+}-dependent$ secretion activator, UL16 binding protein 3, and proenkephalin were down-regulated in the endometritis. Our results suggest that these genes could be useful biomarkers for diagnosis Hanwoo's endometritis.

Dosimetric Evaluation of Synthetic Computed Tomography Technique on Position Variation of Air Cavity in Magnetic Resonance-Guided Radiotherapy

  • Hyeongmin Jin;Hyun Joon An;Eui Kyu Chie;Jong Min Park;Jung-in Kim
    • Progress in Medical Physics
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    • v.33 no.4
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    • pp.142-149
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    • 2022
  • Purpose: This study seeks to compare the dosimetric parameters of the bulk electron density (ED) approach and synthetic computed tomography (CT) image in terms of position variation of the air cavity in magnetic resonance-guided radiotherapy (MRgRT) for patients with pancreatic cancer. Methods: This study included nine patients that previously received MRgRT and their simulation CT and magnetic resonance (MR) images were collected. Air cavities were manually delineated on simulation CT and MR images in the treatment planning system for each patient. The synthetic CT images were generated using the deep learning model trained in a prior study. Two more plans with identical beam parameters were recalculated with ED maps that were either manually overridden by the cavities or derived from the synthetic CT. Dose calculation accuracy was explored in terms of dose-volume histogram parameters and gamma analysis. Results: The D95% averages were 48.80 Gy, 48.50 Gy, and 48.23 Gy for the original, manually assigned, and synthetic CT-based dose distributions, respectively. The greatest deviation was observed for one patient, whose D95% to synthetic CT was 1.84 Gy higher than the original plan. Conclusions: The variation of the air cavity position in the gastrointestinal area affects the treatment dose calculation. Synthetic CT-based ED modification would be a significant option for shortening the time-consuming process and improving MRgRT treatment accuracy.

Unexpected Complications and Safe Management in Laparoscopic Pancreaticoduodenectomy

  • Yuichi Nagakawa;Yatsuka Sahara;Yuichi Hosokawa;Chie Takishita;Tetsushi Nakajima;Yousuke Hijikata;Kazuhiko Kasuya;Kenji Katsumata;Akihiko Tsuchida
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.23-27
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    • 2017
  • Although laparoscopic pancreaticoduodenectomy (LPD) is considered as minimally invasive surgery, an advanced level of laparoscopic skill is still required. LPD comprises various procedures including reconstruction. Therefore, establishment of a safe approach at each step is needed. Prevention of intraoperative bleeding is the most important factor in safe completion of LPD. The establishment of effective retraction methods is also important at each site to prevent vascular injury. I also recommend the "uncinate process first" approach during initial cases of LPD, in which the branches of the inferior pancreaticoduodenal artery are dissected first, at points where they enter the uncinate process. This approach is performed at the left side of the superior mesenteric artery (SMA) before isolating the pancreatic head from the right aspect of the SMA, which allows safe dissection without bleeding. Safe and reliable reconstruction is also important to prevent postoperative complications. Laparoscopic pancreatojejunostomy requires highly skilled suturing technique. Pancreatojejunostomy through a small abdominal incision, as in hybrid-LPD, facilitates reconstruction. In LPD, the surgical view is limited. Therefore, we must carefully verify the position of the pancreaticobiliary limb. A twisted mesentery may cause severe congestion of the pancreaticobiliary limb following reconstruction, resulting in severe complications. We must secure the appropriate position of the pancreaticobiliary limb before starting reconstruction. We describe the incidence of intraoperative and postoperative complications and appropriate technique for safe performance of LPD.

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The Maximum Standardized Uptake Value of 18F-FDG PET/CT in Diabetic Patients with Metastatic Pancreatic Ductal Adenocarcinoma

  • Kyu-hyun Paik;Hyoung Woo Kim;Jong-chan Lee;Jingu Kang;Yoon Suk Lee;Jaihwan Kim;Jin-Hyeok Hwang
    • Journal of Digestive Cancer Research
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    • v.5 no.2
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    • pp.91-96
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    • 2017
  • Background: To evaluate whether DM affects the SUVmax of metastatic lesions on 18F-FDG PET/CT and whether the SUVmax can influence the prognosis of metastatic PDAC patients. Methods: We conducted a retrospective study of 86 patients with metastatic PDAC who underwent PET/CT before treatment. The SUVmax of primary and metastatic lesions and the ratios of the SUVmax were measured. Long-term survival was evaluated using clinical parameters. Results: The mean SUVmax of primary lesion was lower in the DM group than in the non-DM group (4.74 vs. 5.96, p=0.009). The SUVmax for all metastatic lesions, except those in the lung, were lower in the DM group than in the non-DM group, and these differences were statistically significant in the lymph nodes and peritoneum. In the 35 patients with hepatic metastasis, higher ratios of the liver SUVmax significantly correlated with shorter OS (HR, 2.625; p=0.013). Conclusion: DM can influence the lower SUVmax of metastatic lesions as well as primary lesions. The SUVmax ratio of hepatic metastasis could influence on prognosis in metastatic PDAC patients.

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