• Title/Summary/Keyword: Pancreatic mass

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Quantification of Pancreas Surface Lobularity on CT: A Feasibility Study in the Normal Pancreas

  • Riccardo Sartoris;Alberto Calandra;Kyung Jin Lee;Tobias Gauss;Valerie Vilgrain;Maxime Ronot
    • Korean Journal of Radiology
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    • v.22 no.8
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    • pp.1300-1309
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    • 2021
  • Objective: To assess the feasibility and reproducibility of pancreatic surface lobularity (PSL) quantification derived from abdominal computed tomography (CT) in a population of patients free from pancreatic disease. Materials and Methods: This retrospective study included 265 patients free from pancreatic disease who underwent contrast-enhanced abdominal CT between 2017 and 2019. A maximum of 11 individual PSL measurements were performed by two abdominal radiologists (head [5 measurements], body, and tail [3 measurements each]) using dedicated software. The influence of age, body mass index (BMI), and sex on PSL was assessed using the Pearson correlation and repeated measurements. Inter-reader agreement was assessed using the intraclass correlation coefficient (ICC) and Bland Altman (BA) plots. Results: CT images of 15 (6%) patients could not be analyzed. A total of 2750 measurements were performed in the remaining 250 patients (143 male [57%], mean age 45 years [range, 18-91]), and 2237 (81%) values were obtained in the head 951/1250 (76%), body 609/750 (81%), and tail 677/750 (90%). The mean ± standard deviation PSL was 6.53 ± 1.37. The mean PSL was significantly higher in male than in female (6.89 ± 1.30 vs. 6.06 ± 1.31, respectively, p < 0.001). PSL gradually increased with age (r = 0.32, p < 0.001) and BMI (r = 0.32, p < 0.001). Inter-reader agreement was excellent (ICC 0.82 [95% confidence interval 0.72-0.85], with a BA bias of 0.30 and 95% limits of agreement of -1.29 and 1.89). Conclusion: CT-based PSL quantification is feasible with a high success rate and inter-reader agreement in subjects free from pancreatic disease. Significant variations were observed according to sex, age, and BMI. This study provides a reference for future studies.

Platycodi radix beverage ameliorates postprandial lipemia response through lipid clearance of triglyceride-rich lipoprotein: A randomized controlled study in healthy subjects with a high-fat load

  • Lee, Hansol;Lim, Yeni;Park, Soo-yeon;Cho, Soo-Muk;Choe, Jeong-Sook;Jeong, Sewon;Kwak, Jin Sook;Kwon, Oran
    • Nutrition Research and Practice
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    • v.12 no.5
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    • pp.371-377
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    • 2018
  • BACKGROUND/OBJECTIVES: Elevation of postprandial lipemia characterized by a rise in triglyceride (TG)-rich lipoproteins can increase the risk of atherogenesis. The objective of this study was to investigate postprandial lipemia response to a single dietary fat/sugar load test and monitor beneficial changes induced by the consumption of Platycodi radix (AP) beverage in healthy subjects. SUBJECTS/METHODS: A total of 52 subjects were randomly assigned to either placebo or AP beverage group with a high-fat shake in a randomized controlled crossover trial. Postprandial blood was collected at 0, 1, 2, 4, and 6 h and analyzed for TG and lipoprotein lipase mass. Inhibition of pancreatic lipase was determined in vitro. RESULTS: AP inhibited pancreatic lipase activity in vitro ($IC_{50}=5mg/mL$). Compared to placebo beverage, AP beverage consumption with a high-fat shake induced significant increase of plasma lipoprotein lipase mass (P = 0.0111, ${\beta}$ estimate = 4.2948) with significant reduction in very low-density lipoprotein (VLDL) TG concentration (P = 0.038, ${\beta}$ estimate = -52.69) at 6 h. Based on significant correlation between high-fat dietary scores MEDFICTS and postprandial TG responses in VLDL (P = 0.0395, r = 0.2127), subgroup analysis revealed that 6 h-postprandial VLDL TG response was significantly decreased by AP consumption in subjects with MEDFICTS ${\geq}40$ (P = 0.0291, ${\beta}$ estimate = -7214). CONCLUSIONS: AP beverage might have potential to alleviate postprandial lipemia through inhibiting pancreatic lipase activity and elevating lipoprotein lipase mass. Subgroup analysis revealed that subjects with high-fat dietary pattern could be classified as responders to AP beverage among all subjects.

Glucocorticoid treatment independently affects expansion and transdifferentiation of porcine neonatal pancreas cell clusters

  • Kim, Ji-Won;Sun, Cheng-Lin;Jeon, Sung-Yoon;You, Young-Hye;Shin, Ju-Young;Lee, Seung-Hwan;Cho, Jae-Hyoung;Park, Chung-Gyu;Yoon, Kun-Ho
    • BMB Reports
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    • v.45 no.1
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    • pp.51-56
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    • 2012
  • The purpose of this study was to determine the effects of duration and timing of glucocorticoid treatment on the expansion and differentiation of porcine neonatal pancreas cell clusters (NPCCs) into ${\beta}$-cells. After transplantation of NPCCs, the ductal cyst area and ${\beta}$-cell mass in the grafts both showed positive and negative correlations with duration of dexamethasone (Dx) treatment. Pdx-1 and HNF-3${\beta}$ gene expression was significantly downregulated following Dx treatment, whereas PGC-1${\alpha}$ expression increased. Pancreatic duct cell apoptosis significantly increased following Dx treatment, whereas proliferation did not change. Altogether, transdifferentiation of porcine NPCCs into ${\beta}$-cells was influenced by the duration of Dx treatment, which might have been due to the suppression of key pancreatic transcription factors. PGC-1${\alpha}$ plays an important role in the expansion and transdifferentiation of porcine NPCCs, and the initial 2 weeks following transplantation of porcine NPCCs is a critical period in determining the final ${\beta}$-cell mass in grafts.

A Case of Metastatic Pancreatic Cancer Treated with FOLFIRINOX as Second-Line Chemotherapy after Gemcitabine Failure (FOLFIRINOX 병합요법을 통한 이차 항암화학요법으로 완전 관해를 획득한 진행성 췌장암 증례)

  • Jae Min Lee;Kwang Hyun Chung;Jin Myung Park;Sang Hyub Lee;Ji Kon Ryu;Yong-Tae Kim
    • Journal of Digestive Cancer Research
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    • v.2 no.1
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    • pp.28-31
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    • 2014
  • Pancreatic cancer is a highly aggressive cancer with poor prognosis. Although, gemcitabine is the current standard regimen as first-line chemotherapy for advanced pancreatic cancer, effective regimens of second-line chemotherapy after gemcitabine failure have not been established yet. We report a case of gemcitabine refractory pancreatic cancer treated with second-line chemotherapy with FOLFIRINOX regimen. A 57-year-old-woman visited our hospital for pancreatic body mass detected by computed tomography (CT). The patient underwent distal pancreatectomy and splenectomy and the pathologic results after surgery demonstrated adenocarcinoma. Follow-up was performed after surgery and CT and positron emission tomography (PET) 4 months after surgery revealed multiple hepatic metastases. The patient underwent first-line chemotherapy with gemcitabine and erlotinib for recurred pancreatic cancer. However, CT after 7 cycles of the chemotherapy showed the progression of multiple hepatic metastases and switch to second-line chemotherapy with FOLFIRINOX was initiated. CT after 16 cycles of the FOLFIRINOX showed the complete remission of multiple hepatic metastases. The patient was admitted for infective endocarditis with septic pneumonia 17 months after the initiation of FOLFIRINOX. However, the patients died from the progression of septic embolism and acute respiratory distress syndrome.

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Combination Therapy of Prednisolone and Toceranib Phosphate in a Dog with Malignant Metastatic Insulinoma

  • Kang, Yeo-Lim;Park, Hee-Myung;Kang, Min-Hee
    • Journal of Veterinary Clinics
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    • v.35 no.5
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    • pp.211-214
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    • 2018
  • A 14-year-old intact female Yorkshire terrier was presented with a 2-month history of shivering, intermittent pelvic limb weakness and collapse. Biochemical abnormalities revealed inappropriately increased serum insulin concentration with persistent hypoglycemia. Abdominal ultrasound revealed multiple various sized nodules in liver and fine-needle aspirates of the nodule showed typical neuroendocrine cells with high cellularity. Computed tomography (CT) revealed well-defined hyperattenuating mass in the right pancreatic lobe with homogenous enhancement. CT findings were consistent with a pancreatic tumor with malignant metastasis. Treatment was initiated with low-dose prednisolone and toceranib phosphate. The dog was maintained stable with no more progression of clinical signs and it is worth to try toceranib phosphate in a dog with metastatic insulinoma for improving the quality of life.

Ectopic insulinoma in a dog with insulin-induced hypoglycemia: a case report

  • Jiwon Kim;Insun Hwang;Danbee Kwon;Kanghyo Park;Hakyoung Yoon
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.39.1-39.6
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    • 2023
  • A 7-year-old spayed female Shih Tzu dog was presented for evaluation of recurrent hypoglycemia. Serum insulin levels during hypoglycemia were 35.3 µIU/mL. Ultrasonography and computed tomography showed a mesenteric nodule between the kidney and the portal vein, but no pancreatic mass was observed. During surgery, the nodule had neither anatomical adhesions nor vascular connections to the pancreas. Pancreatic inspection and palpation revealed no abnormalities. Hypoglycemia improved after resection of the nodule. Histopathological examination confirmed the nodule to be an islet cell carcinoma. Although extremely rare, ectopic insulinoma should be considered as a possible cause of insulininduced hypoglycemia in dogs.

Comparative Analysis of Phospholipase D2 Localization in the Pancreatic Islet of Rat and Guinea Pig

  • Ryu, Gyeong-Ryul;Kim, Myung-Jun;Song, Chan-Hee;Min, Do-Sik;Rhie, Duck-Joo;Yoon, Shin-Hee;Hahn, Sang-June;Kim, Myung-Suk;Jo, Yang-Hyeok
    • The Korean Journal of Physiology and Pharmacology
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    • v.7 no.4
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    • pp.211-215
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    • 2003
  • To examine the localization pattern of phospholipase D2 (PLD2) in the pancreatic islet (the islet of Langerhans) depending on species, we conducted a morphological experiment in the rat and guinea pig. Since individual islets display a typical topography with a central core of B cell mass and a peripheral boundary of A, D, and PP cells, double immunofluorescent staining with a panel of antibodies was performed to identify PLD2-immunoreactive cells in the islets PLD2 immunoreactivity was mainly present in A and PP cells of the rat pancreatic islets. And yet, in the guinea pig, PLD2 immunoreactivity was exclusively localized in A cells, and not in PP cells. These findings suggest a possibility that PLD2 is mainly located in A cells of rodent pancreatic islets, and that the existence of PLD2 in PP cells is not universal in all species. Based on these results, it is suggested that PLD2 may play a significant role in the function of A and/or PP cells via a PLD-mediated signaling pathway.

Anti-hyperlipidemic Effect of Insamsansa-eum in Mice

  • Jung, Sang-Hyun;Ko, Chang-Nam;Bae, Hyung-Sup;Kim, Young-Suk;Cho, Ki-Ho;Min, Sung-Won;Kim, Dong-Hyun
    • Natural Product Sciences
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    • v.14 no.4
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    • pp.215-220
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    • 2008
  • Hypolipidemic effect of Insamsansa-eum (ISE, Ren-Shen-Shan-Zah-Yin in Chinese) consisted of Red ginseng (RG; the steamed root of Panax ginseng C.A. Meyer) and Crataegii fructus (CF, the fruit of Crataegus pinnatifida BGE) is used frequently in China and Korea as a herbal medicine to treat arteriosclerosis, was investigated. Treatment of ISE significantly reduced blood triglyceride (TG) and total cholesterol (TC) levels in Triton WR-1339-induced hyperlipidemic mice and serum TG levels in corn oil-induced hypertriglyceridemic mice. ISE significantly lowered the high blood TG and TC levels as well as body and epididymal mass weights in hyperlipidemic mice induced by long-term feeding of a high-fat diet and increased blood HDL cholesterol level. ISE and its ingredients, RG and CF, inhibited pancreatic lipase and HMG-CoA reductase activities. Of its ingredients, RG reduced the blood TC level and HMG-CoA reductase activity more than CF. CF reduced blood TG level and pancreatic lipase activity more than RG. These finding suggest that the antihyperlipidemic effect of ISE may be due to synergistic inhibition of HMG-CoA reductase and pancreatic lipase by RG and CF, and that ISE may be effective hypolipidemic agents.

Heterotopic Pancreas Presented as Duodenal Tumor with Obstruction

  • Kim, Sung Heun;Nam, So Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.280-285
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    • 2015
  • Heterotopic pancreas (HP) is defined as pancreatic tissue lacking anatomic and vascular continuity with the main body of the pancreas. Most are asymptomatic, but can cause ulcer, bleeding, intussusception, and mechanical obstruction. Herein, we presented one case of HP presented as duodenal tumor causing duodenal obstruction. A 7-year-old girl visited the emergency room for abdominal pain with vomiting for 24 hours. Computed tomography and upper gastrointestinal series revealed a polypoid mass with short stalk in the 2nd portion of duodenum. We attempted an endoscopic removal. However, the lumen was nearly obstructed by the mass and the stalk was too broad and hard to excise. The mass was surgically removed via duodenotomy. It was confirmed as a HP with ductal and acini components (type 2 by Heinrich classification). Postoperatively, the patient has been well without any complication and recurrence.

Quantitative Analysis of Pancreatic Fat in Children with Obesity Using Magnetic Resonance Imaging and Ultrasonography

  • Lee, Mu Sook;Lee, Jeong Sub;Kim, Bong Soo;Kim, Doo Ri;Kang, Ki Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.6
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    • pp.555-563
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    • 2021
  • Purpose: The aim of this study was to evaluate the pancreatic fat fraction (PFF) using magnetic resonance imaging (MRI) in children with and without obesity and to correlate PFF with body mass index (BMI) z-score, hepatic fat fraction (HFF), and ultrasonography-derived pancreato-perihepatic fat index (PPHFI). Methods: This prospective study included 45 children with obesity and 19 without obesity (control group). PFF and HFF were quantitatively assessed using the abdominal multi-echo Dixon method for MRI. The PPHFI was assessed using transabdominal ultrasonography. Anthropometric, MRI, and ultrasonographic characteristics were compared between the two groups. Correlations between PFF, HFF, PPHFI, and BMI z-scores in each group were also analyzed. Results: The PFF, HFF, PPHFI, and BMI z-score were higher in the group with obesity than in the control group (PFF: 6.65±3.42 vs. 1.78±0.55, HFF: 19.5±13.0 vs. 2.31±1, PPHFI: 3.65 ±1.63 vs. 0.94±0.31, BMI z-score: 2.27±0.56 vs. 0.42±0.54, p<0.01, respectively). PFF was correlated with BMI z-scores, PPHFI, and HFF in the obesity group, and multivariate analysis showed that PFF was strongly correlated with BMI z-score and PPHFI (p<0.05). The BMI z-score was strongly correlated with PFF in the control group (p<0.01). Conclusion: These results suggest that MRI-derived PFF measures are associated with childhood obesity. PFF and PPHFI were also highly correlated in the obesity group. Therefore, PFF may be an objective index of pancreatic fat content and has the potential for clinical utility as a non-invasive biomarker for the assessment of childhood obesity.