The Role of Neutrophils in Pancreatic Cancer

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Introducer-free MIS-assisted Ventriculoperitoneal Shunt Placement: A Technical Document

Background The placement of the distal catheter of a ventriculoperitoneal shunt (VPS) can be challenging in patients with a large body habitus. Given the complications associated with ventriculoperitoneal shunts and known infection risk of obese patients, new techniques for VPS placement that bypass the abdominal fat must be sought. By avoiding the abdominal fat, decreased complications and infection risk may be possible. Objective The objective of this technical document is to describe a laparoscopic approach to the abdominal cavity during ventriculoperitoneal shunt surgery that makes use of a direct tunneling technique into the peritoneal space. Methods We perform a ventriculoperitoneal shunt placement with distal catheter implantation under laparoscopic guidance. Tunneling of the distal abdominal catheter was done through the abdominal fascia directly, without creation of a stab incision for the insertion site. Intraoperative video media was obtained using video footage from OPTIVIEW camera. Results We have found this technique to be feasible and useful for patients with large body habitus. By eliminating the incision overlying the catheter there is decreased risk for infection by skin flora and overall decreased risk of complications. Conclusion Our technique of tunneling directly into the abdominal cavity is both novel and feasible. To our knowledge this is the first time this technique has been described. We believe that further study of this technique in a case series may highlight its advantages in a certain subpopulation of patients requiring VPS

Androgen Receptor Inhibition Suppresses Anti-Tumor Neutrophil Response Against Bone Metastatic Prostate Cancer via Regulation of TβRI Expression

Bone metastatic disease of prostate cancer (PCa) is incurable and progression in bone is largely dictated by tumor-stromal interactions in the bone microenvironment. We showed previously that bone neutrophils initially inhibit bone metastatic PCa growth yet metastatic PCa becomes resistant to neutrophil response. Further, neutrophils isolated from tumor-bone lost their ability to suppress tumor growth through unknown mechanisms. With this study, our goal was to define the impact of metastatic PCa on neutrophil function throughout tumor progression and to determine the potential of neutrophils as predictive biomarkers of metastatic disease. Using patient peripheral blood polymorphonuclear neutrophils (PMNs), we identified that PCa progression dictates PMN cell surface markers and gene expression, but not cytotoxicity against PCa. Importantly, we also identified a novel phenomenon in which second generation androgen deprivation therapy (ADT) suppresses PMN cytotoxicity via increased transforming growth factor beta receptor I (TβRI). High dose testosterone and genetic or pharmacologic TβRI inhibition rescued androgen receptor-mediated neutrophil suppression and restored neutrophil anti-tumor immune response. These studies highlight the ability to leverage standard-care ADT to generate neutrophil anti-tumor responses against bone metastatic PCa

Nonfunctioning cystic neuroendocrine tumor of pancreas. Presentation of an unusual case

Universidade Federal de São Paulo, Escola Paulista Med, Disciplina Gastroenterol Quirurg, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Disciplina Gastroenterol Quirurg, São Paulo, BrazilWeb of Scienc