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Abstract
Acute pancreatitis is an inflammation of the glandular parenchyma of the retroperitoneal organ that leads to injury with or without subsequent destruction of the pancreatic acini. This inflammatory process can either result in a self-limited disease or involve life-threatening multiorgan complications. Chronic pancreatitis consists of endocrine and exocrine gland dysfunction that develops secondary to progressive inflammation and chronic fibrosis of the pancreatic acini with permanent structural damage. Recurrent attacks of acute pancreatitis can result in chronic pancreatitis; acute and chronic pancreatitis are different diseases with separate morphologic patterns. Acute pancreatitis has an increasing incidence but a decreasing mortality.
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Affiliation(s)
- Abdulrahman Y Hammad
- Department of Surgery, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA
| | - Michael Ditillo
- Department of Surgery, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA
| | - Lourdes Castanon
- Department of Surgery, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA.
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Jiang L, Ning D, Cheng Q, Chen XP. Endoscopic versus surgical drainage treatment of calcific chronic pancreatitis. Int J Surg 2018; 54:242-247. [DOI: 10.1016/j.ijsu.2018.04.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 03/22/2018] [Accepted: 04/13/2018] [Indexed: 01/10/2023]
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Colling KP, Bellin MD, Schwarzenberg SJ, Berry L, Wilhelm JJ, Dunn T, Pruett TL, Sutherland DER, Chinnakotla S, Dunitz JM, Beilman GJ. Total Pancreatectomy With Intraportal Islet Autotransplantation as a Treatment of Chronic Pancreatitis in Patients With CFTR Mutations. Pancreas 2018; 47:238-244. [PMID: 29206667 DOI: 10.1097/mpa.0000000000000968] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Chronic pancreatitis (CP) is an infrequent but debilitating complication associated with CFTR mutations. Total pancreatectomy with islet autotransplantation (TPIAT) is a treatment option for CP that provides pain relief and preserves β-cell mass, thereby minimizing the complication of diabetes mellitus. We compared outcomes after TPIAT for CP associated with CFTR mutations to CP without CTFR mutations. METHODS All TPIATs performed between 2002 and 2014 were retrospectively reviewed: identifying 20 CFTR homozygotes (cystic fibrosis [CF] patients), 19 CFTR heterozygotes, and 20 age-/sex-matched controls without CFTR mutations. Analysis of variance and χ tests were used to compare groups. RESULTS Baseline demographics were not different between groups. Postoperative glycosylated hemoglobin and C-peptide levels were similar between groups, as were islet yield and rate of postoperative complications. At 1 year, 40% of CF patients, 22% of CFTR heterozygotes, and 35% of control patients were insulin independent. CONCLUSION Total pancreatectomy with islet autotransplantation is a safe, effective treatment option for CF patients with CP, giving similar outcomes for those with other CP etiologies.
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Fan CJ, Hirose K, Walsh CM, Quartuccio M, Desai NM, Singh VK, Kalyani RR, Warren DS, Sun Z, Hanna MN, Makary MA. Laparoscopic Total Pancreatectomy With Islet Autotransplantation and Intraoperative Islet Separation as a Treatment for Patients With Chronic Pancreatitis. JAMA Surg 2017; 152:550-556. [PMID: 28241234 DOI: 10.1001/jamasurg.2016.5707] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Importance Pain management of patients with chronic pancreatitis (CP) can be challenging. Laparoscopy has been associated with markedly reduced postoperative pain but has not been widely applied to total pancreatectomy with islet autotransplantation (TPIAT). Objective To examine the feasibility of using laparoscopic TPIAT (L-TPIAT) in the treatment of CP. Design, Setting, and Participants Thirty-two patients with CP presented for TPIAT at a tertiary hospital from January 1, 2013, through December 31, 2015. Of the 22 patients who underwent L-TPIAT, 2 patients converted to an open procedure because of difficult anatomy and prior surgery. Pain and glycemic outcomes were recorded at follow-up visits every 3 to 6 months postoperatively. Main Outcomes and Measures Operative outcomes included operative time, islet isolation time, warm ischemia time, islet equivalent (IE) counts, estimated blood loss, fluid resuscitation, and blood transfusions. Postoperative outcomes included length of stay, all-cause 30-day readmission rate, postoperative complications, mortality rate, subjective pain measurements, opioid use, random C-peptide levels, insulin requirements, and glycated hemoglobin level. Results Of the 32 patients who presented for TPIAT, 20 underwent L-TPIAT (8 men and 12 women; mean [SD] age, 39 [13] years; age range, 21-58 years). Indication for surgery was CP attributable to genetic mutation (n = 9), idiopathic pancreatitis (n = 6), idiopathic pancreatitis with pancreas divisum (n = 3), and alcohol abuse (n = 2). Mean (SD) operative time was 493 (78) minutes, islet isolation time was 185 (37) minutes, and warm ischemia time was 51 (62) minutes. The mean (SD) IE count was 1325 (1093) IE/kg. The mean (SD) length of stay was 11 (5) days, and the all-cause 30-day readmission rate was 35% (7 of 20 patients). None of the patients experienced postoperative surgical site infection, hernia, or small-bowel obstruction, and none died. Eighteen patients (90%) had a decrease or complete resolution of pain, and 12 patients (60%) no longer required opioid therapy at a median follow-up period of 6 months. Postoperative random insulin C-peptide levels were detectable in 19 patients (95%) at a median follow-up of 10.4 months. At a median follow-up of 12.5 months, 5 patients (25%) were insulin independent, whereas 9 patients (45%) required 1 to 10 U/d, 5 patients (25%) required 11 to 20 U/d, and 1 patient (5%) required greater than 20 U/d of basal insulin. The mean (SD) glycated hemoglobin level was 7.4% (0.5%). Conclusions and Relevance This study represents the first series of L-TPIAT, demonstrating its safety and feasibility. Our approach enables patients to experience shorter operative times and the benefits of laparoscopy, including reduced length of stay and quicker opioid independence.
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Affiliation(s)
- Caleb J Fan
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Kenzo Hirose
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland3Department of Surgery, University of California, San Francisco
| | - Christi M Walsh
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland
| | | | - Niraj M Desai
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Vikesh K Singh
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Rita R Kalyani
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Daniel S Warren
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Zhaoli Sun
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Marie N Hanna
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Martin A Makary
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland
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Kilburn DJ, Chiow AKH, Leung U, Siriwardhane M, Cavallucci DJ, Bryant R, O'Rourke NA. Early Experience with Laparoscopic Frey Procedure for Chronic Pancreatitis: a Case Series and Review of Literature. J Gastrointest Surg 2017; 21:904-909. [PMID: 28025771 DOI: 10.1007/s11605-016-3343-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 12/15/2016] [Indexed: 01/31/2023]
Abstract
The Frey procedure has been demonstrated to be an effective surgical technique to treat patients with painful large duct chronic pancreatitis. More commonly reported as an open procedure, we report our experience with a minimally invasive approach to the Frey procedure. Four consecutive patients underwent a laparoscopic Frey procedure at our institution from January 2012 to July 2015. We herein report our technique and describe short- and medium-term outcomes. The median age was 40 years old. The median duration of pancreatic pain prior to surgery was 12 years. Median operative time and intraoperative blood loss was 130 min (100-160 min) and 60 mL (50-100 mL), respectively. The median length of stay was 7 days (3-40 days) and median follow-up was 26 months (12-30 months). There was one major postoperative complication requiring reoperation. Within 6 months, in all four patients, frequency of pain and analgesic requirement reduced significantly. Two patients appeared to have resolution of pancreatic exocrine insufficiency. The Frey procedure is possible laparoscopically with acceptable short- and medium-term outcomes in well-selected patients.
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Affiliation(s)
- Daniel J Kilburn
- Hepatopancreatobiliary Unit, Department of Surgery, Royal Brisbane Hospital, Brisbane, Queensland, 4029, Australia.,School of Medicine, The University of Queensland, Brisbane, Australia
| | - Adrian K H Chiow
- Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore, Singapore
| | - Universe Leung
- Hepatopancreatobiliary Unit, Department of Surgery, Royal Brisbane Hospital, Brisbane, Queensland, 4029, Australia
| | - Mehan Siriwardhane
- Hepatopancreatobiliary Unit, Department of Surgery, Royal Brisbane Hospital, Brisbane, Queensland, 4029, Australia
| | - David J Cavallucci
- Hepatopancreatobiliary Unit, Department of Surgery, Royal Brisbane Hospital, Brisbane, Queensland, 4029, Australia.,School of Medicine, The University of Queensland, Brisbane, Australia
| | - Richard Bryant
- Hepatopancreatobiliary Unit, Department of Surgery, Royal Brisbane Hospital, Brisbane, Queensland, 4029, Australia
| | - Nicholas A O'Rourke
- Hepatopancreatobiliary Unit, Department of Surgery, Royal Brisbane Hospital, Brisbane, Queensland, 4029, Australia. .,School of Medicine, The University of Queensland, Brisbane, Australia. .,, Wesley Medical Centre Suite 47, 40 Chasely Street, Auchenflower, Brisbane, Queensland, 4066, Australia.
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Trikudanathan G, Munigala S, Barlass U, Malli A, Han Y, Sekulic M, Bellin M, Chinnakotla S, Dunn T, Pruett T, Beilman G, Peralta JV, Arain M, Amateau S, Mallery S, Freeman ML, Attam R. Evaluation of Rosemont criteria for non-calcific chronic pancreatitis (NCCP) based on histopathology - A retrospective study. Pancreatology 2016; 17:63-69. [PMID: 27836330 DOI: 10.1016/j.pan.2016.10.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 10/12/2016] [Accepted: 10/21/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Rosemont classification for chronic pancreatitis has not been evaluated specifically in non-calcific chronic pancreatitis (NCCP) patients and to this date, it has not been correlated with the gold standard namely histopathology. OBJECTIVE To assess the correlation of EUS Rosemont criteria for NCCP with histopathology from surgical specimens and evaluate the impact of age, sex, BMI, smoking and alcohol on Rosemont classification. METHODS Adult patients undergoing TPIAT for NCCP between July 2009 and January 2013 were identified from our institutional database. The presence or absence of standard and Rosemont (major and minor) criteria were determined by expert endosonographers using linear endosonography. Patients were categorized into normal, indeterminate and suggestive with CP based on Rosemont classification. Histology was obtained at time of TPIAT from the resected pancreas by wedge biopsy of head, body and tail. All histopathology were re-reviewed by a GI pathologist blinded to endosonographic features and clinical outcomes. Available pancreatic tissue was graded for severity of intralobular and perilobular pancreatic fibrosis by the Ammann classification system. RESULTS 50 patients with NCCP (42 females, mean age± SD = 37.9 ± 10.8) underwent TPIAT with preoperative EUS during the study period. Univariate analysis of features such as age, sex, BMI, smoking and alcohol history showed no significant difference between patients identified as normal and those identified as indeterminate/suggestive (p > 0.05). Rosemont "Normal" was poor in excluding CP as 5/9 patients (55.5%) had CP on histopathology. 25/26 patients (96.2%) with features "suggestive" of CP had evidence of CP on histopathology. 12/15 patients (80.0%) with "indeterminate" features had CP on histopathology. CONCLUSIONS Rosemont classification can be used independent of patient characteristics (age, sex and BMI) and environmental factors (smoking and alcohol exposure). In our cohort, Rosemont classification was strongly predictive of CP in patients with features "suggestive" of CP. However, "normal" Rosemont classification had poor correlation in this study. This is maybe due to lack of true comparator "normal" pancreas which cannot be obtained reasonably. The strength of agreement for diagnosis of CP was substantial between the standard and Rosemont criteria.
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Affiliation(s)
| | - Satish Munigala
- Division of Gastroenterology, St Louis University School of Medicine, USA
| | - Usman Barlass
- Department of Surgery, University of Minnesota, Minneapolis, USA
| | - Ahmad Malli
- Department of Internal Medicine, University of Minnesota, Minneapolis, USA
| | - Yusheng Han
- Department of Pathology, University of Minnesota, Minneapolis, USA
| | - Miroslav Sekulic
- Department of Pathology, University of Minnesota, Minneapolis, USA
| | - Melena Bellin
- The Schulze Diabetes Institute, University of Minnesota, Minneapolis, MN, USA
| | | | - Ty Dunn
- Department of Surgery, University of Minnesota, Minneapolis, USA
| | - Timothy Pruett
- Department of Surgery, University of Minnesota, Minneapolis, USA
| | - Gregory Beilman
- Department of Surgery, University of Minnesota, Minneapolis, USA
| | - Jose-Vega Peralta
- Division of Gastroenterology, University of Minnesota, Minneapolis, USA
| | - Mustafa Arain
- Division of Gastroenterology, University of Minnesota, Minneapolis, USA
| | - Stuart Amateau
- Division of Gastroenterology, University of Minnesota, Minneapolis, USA
| | - Shawn Mallery
- Division of Gastroenterology, University of Minnesota, Minneapolis, USA
| | - Martin L Freeman
- Division of Gastroenterology, University of Minnesota, Minneapolis, USA
| | - Rajeev Attam
- Division of Gastroenterology, University of Minnesota, Minneapolis, USA.
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Falzon M, Bhatia V. Role of Parathyroid Hormone-Related Protein Signaling in Chronic Pancreatitis. Cancers (Basel) 2015; 7:1091-108. [PMID: 26095761 PMCID: PMC4491701 DOI: 10.3390/cancers7020826] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/05/2015] [Accepted: 06/09/2015] [Indexed: 12/21/2022] Open
Abstract
Chronic pancreatitis (CP), a progressive inflammatory disease where acini are destroyed and replaced by fibrous tissue, increases the risk for pancreatic cancer. Risk factors include alcohol, smoking, and obesity. The effects of these risk factors are exacerbated in patients with mutations in genes that predispose to CP. The different environmental and genetic factors produce the same clinical phenotype; once CP develops, disease course is the same regardless of etiology. Critical questions still need to be answered to understand what modifies predisposition to develop CP in persons exposed to risk factors. We postulate that risk factors modulate endogenous pathways, with parathyroid hormone-related protein (PTHrP) signaling being one such pathway. In support, PTHrP levels are elevated in mice treated with alcohol, and in mouse models of cerulein- and pancreatic duct ligation-induced CP. Disrupting the Pthrp gene in acinar cells exerts protective effects (decreased edema, histological damage, amylase and cytokine release, and fibrosis) in these CP models. PTHrP levels are elevated in human CP. Currently, CP care lacks specific pharmacological interventions. Targeting PTHrP signaling may present a novel therapeutic strategy that inhibits pancreatic inflammation and fibrosis, especially since the risk of developing pancreatic cancer is strongly associated with duration of chronic inflammation.
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Affiliation(s)
- Miriam Falzon
- Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555, USA.
| | - Vandanajay Bhatia
- Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555, USA.
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Colling KP, Blondet JJ, Balamurugan AN, Wilhelm JJ, Dunn T, Pruett TL, Sutherland DER, Chinnakotla S, Bellin M, Beilman GJ. Positive sterility cultures of transplant solutions during pancreatic islet autotransplantation are associated infrequently with clinical infection. Surg Infect (Larchmt) 2015; 16:115-23. [PMID: 25668050 DOI: 10.1089/sur.2013.224] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Chronic pancreatitis is a painful and often debilitating disease. Total pancreatectomy with intra-portal islet autotransplantation (TP-IAT) is a treatment option that allows for pain relief and preservation of beta-cell mass, thereby minimizing the complication of diabetes mellitus. Cultures of harvested islets are often positive for bacteria, possibly due to frequent procedures prior to TP-IAT, such as endoscopic retrograde cholangiopancreatography (ERCP), stenting, or other operative drainage procedures. It is unclear if these positive cultures contribute to post-operative infections. HYPOTHESIS We hypothesized that positive cultures of transplant solutions will not be associated with increased infection risk. METHODS We reviewed retrospectively the sterility cultures from both the pancreas preservation solution used to transport the pancreas and the final islet preparation for intra-portal infusion of patients who underwent TP-IAT between April 2006 and November 2012. Two hundred fifty-one patients underwent total, near-total, or completion pancreatectomy with IAT and had complete sterility cultures. All patients received prophylactic peri-operative antibiotics. Patients with positive pancreas preservation solution or islet sterility cultures received further antibiotics for 5-7 d. Patients' medical records were reviewed for post-operative infections and causative organisms. RESULTS Of the 251 patients included, 151 (61%) had one or more positive bacterial cultures from the pancreas preservation solution or final islet product. Seventy-three of the 251 patients (29%) had an infectious complication. Thirty-four of the 73 (22%) patients with a post-operative infectious complication also had positive cultures. Only seven of 151 patients with positive cultures (4.7%) had an infectious complication caused by the same organism as that isolated from their pancreas or islet cell preparation. CONCLUSIONS In autologous islet preparations, isolation solutions frequently have positive cultures, but this finding is associated infrequently with clinical infection.
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Affiliation(s)
- Kristin P Colling
- 1 Department of Surgery, University of Minnesota , Minneapolis, Minnesota
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Kurtycz DFI, Field A, Tabatabai L, Michaels C, Young N, Schmidt CM, Farrell J, Gopal D, Simeone D, Merchant NB, Pitman MB. Post-brushing and fine-needle aspiration biopsy follow-up and treatment options for patients with pancreatobiliary lesions: The Papanicolaou Society of Cytopathology Guidelines. Cytojournal 2014; 11:5. [PMID: 25191519 PMCID: PMC4153339 DOI: 10.4103/1742-6413.133356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 02/06/2014] [Indexed: 12/28/2022] Open
Abstract
The Papanicolaou Society of Cytopathology (PSC) has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) biopsy, techniques of EUS-FNA, terminology and nomenclature for pancreatobiliary cytology, ancillary testing and post-procedure management. All documents are based on the expertise of the authors, a review of the literature and discussions of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the PSC web site (www.papsociety.org). This document selectively presents the results of these discussions and focuses on the follow-up and treatment options for patients after procedures performed for obtaining cytology samples for the evaluation of biliary strictures and solid and cystic masses in the pancreas. These recommendations follow the six-tiered terminology and nomenclature scheme proposed by committee III.
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Affiliation(s)
| | - Andrew Field
- Department of Pathology, Saint Vincent's Hospital, Sydney, Australia
| | | | - Claire Michaels
- Department of Surgery, Case Western Reserve University, Philadelphia, PA
| | - Nancy Young
- Department of Surgery, Albert Einstein College of Medicine, Philadelphia, PA
| | | | | | - Deepak Gopal
- Department of Surgery, Division of Gastroenterology, University of Wisconsin, USA
| | | | - Nipun B. Merchant
- Department of Medicine, Division of Surgical Oncology, Vanderbilt University, USA
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Chen H, Mrazek AA, Wang X, Ding C, Ding Y, Porro LJ, Liu H, Chao C, Hellmich MR, Zhou J. Design, synthesis, and characterization of novel apigenin analogues that suppress pancreatic stellate cell proliferation in vitro and associated pancreatic fibrosis in vivo. Bioorg Med Chem 2014; 22:3393-404. [PMID: 24837156 DOI: 10.1016/j.bmc.2014.04.043] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 04/14/2014] [Accepted: 04/22/2014] [Indexed: 02/07/2023]
Abstract
Accumulating evidence suggests that activated pancreatic stellate cells (PSC) play an important role in chronic pancreatitis (CP), and inhibition of the activated PSC is considered as a potential strategy for the treatment and prevention of CP. Herein, we disclose our findings that apigenin and its novel analogues suppress the proliferation and induce apoptosis in PSC, which reduce the PSC-mediated fibrosis in CP. Chemical modifications of apigenin have been directed to build a focused library of O-alkylamino-tethered apigenin derivatives at 4'-O position of the ring C with the attempt to enhance the potency and drug-like properties including aqueous solubility. A number of compounds such as 14, 16, and 24 exhibited potent antiproliferative effects as well as improved aqueous solubility. Intriguingly, apigenin, new analogues 23 and 24 displayed significant efficacy to reduce pancreatic fibrosis even at a low dose of 0.5mg/kg in our proof-of-concept study using a preclinical in vivo mouse model of CP.
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Affiliation(s)
- Haijun Chen
- Chemical Biology Program, Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555, United States
| | - Amy A Mrazek
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, United States
| | - Xiaofu Wang
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, United States
| | - Chunyong Ding
- Chemical Biology Program, Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555, United States
| | - Ye Ding
- Chemical Biology Program, Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555, United States
| | - Laura J Porro
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, United States
| | - Huiling Liu
- Chemical Biology Program, Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555, United States
| | - Celia Chao
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, United States
| | - Mark R Hellmich
- Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, United States.
| | - Jia Zhou
- Chemical Biology Program, Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX 77555, United States.
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Pitman MB, Layfield LJ. Guidelines for pancreaticobiliary cytology from the Papanicolaou Society of Cytopathology: A review. Cancer Cytopathol 2014; 122:399-411. [PMID: 24777782 DOI: 10.1002/cncy.21427] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 12/30/2022]
Abstract
The newest installment on state-of-the-art standards of practice in cytopathology from the Papanicolaou Society of Cytopathology (PSC) focuses on the pancreaticobiliary system. Similar to the National Cancer Institute recommendations for aspiration cytology of the thyroid, the PSC guidelines for pancreaticobiliary cytology addresses indications, techniques, terminology and nomenclature, ancillary studies, and postprocedure management. Each committee was composed of a multidisciplinary group of experts in diagnosing, managing, and treating patients with pancreaticobiliary disease. Draft documents were posted on an interactive Web-based forum hosted by the PSC Web site (www.papsociety.org) and the topics of terminology, ancillary testing, and management were presented at national and international meetings over an 18-month period for discussion and feedback from practicing pathologists around the world. This review provides a synopsis of these guidelines.
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Affiliation(s)
- Martha B Pitman
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
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12
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Kurtycz D, Tabatabai ZL, Michaels C, Young N, Schmidt CM, Farrell J, Gopal D, Simeone D, Merchant NB, Field A, Pitman MB. Postbrushing and fine-needle aspiration biopsy follow-up and treatment options for patients with pancreatobiliary lesions: The papanicolaou society of cytopathology guidelines. Diagn Cytopathol 2014; 42:363-71. [DOI: 10.1002/dc.23121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 01/15/2014] [Indexed: 12/28/2022]
Affiliation(s)
- Daniel Kurtycz
- Department of Pathology; University of Wisconsin, Wisconsin State Laboratory of Hygiene; Madison Wisconsin
| | | | - Claire Michaels
- Department of Pathology; Case Western Reserve University; Cleveland Ohio
| | - Nancy Young
- Department of Pathology; Albert Einstein College of Medicine; Bronx New York
| | - C. Max Schmidt
- Department of Surgery; Indiana University; Indianapolis Indiana
| | - James Farrell
- Department of Medicine; UCLA School of Medicine; Los Angeles California
| | - Deepak Gopal
- Division of Gastroenterology, Department of Medicine; University of Wisconsin; Madison Wisconsin
| | - Diane Simeone
- Department of Surgery; University of Michigan; Michigan
| | - Nipun B. Merchant
- Division of Surgical Oncology, Department of Medicine; Vanderbilt University, Vanderbilt; Nashville Tennessee
| | - Andrew Field
- Department of Pathology; St. Vincent's Hospital Sydney Australia
| | - Martha Bishop Pitman
- Department of Pathology, Massachusetts General Hospital; Harvard Medical School; Boston Massachusetts
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Galvani CA, Rodriguez Rilo H, Samamé J, Porubsky M, Rana A, Gruessner RWG. Fully robotic-assisted technique for total pancreatectomy with an autologous islet transplant in chronic pancreatitis patients: results of a first series. J Am Coll Surg 2013; 218:e73-8. [PMID: 24559970 DOI: 10.1016/j.jamcollsurg.2013.12.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 12/03/2013] [Accepted: 12/09/2013] [Indexed: 01/02/2023]
Affiliation(s)
- Carlos A Galvani
- Section of Minimally Invasive and Robotic Surgery, Department of Surgery, University of Arizona, Tucson, AZ.
| | - Horacio Rodriguez Rilo
- Institute for Cellular Transplantation, Department of Surgery, University of Arizona, Tucson, AZ
| | - Julia Samamé
- Section of Minimally Invasive and Robotic Surgery, Department of Surgery, University of Arizona, Tucson, AZ
| | - Marian Porubsky
- Division of Transplantation and Hepatopancreaticobiliary Surgery, Department of Surgery, University of Arizona, Tucson, AZ
| | - Abbas Rana
- Division of Transplantation and Hepatopancreaticobiliary Surgery, Department of Surgery, University of Arizona, Tucson, AZ
| | - Rainer W G Gruessner
- Division of Transplantation and Hepatopancreaticobiliary Surgery, Department of Surgery, University of Arizona, Tucson, AZ
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