A case of gangliocytic paraganglioma in the ampulla of Vater

<p>Abstract</p> <p>Background</p> <p>Duodenal gangliocytic paraganglioma is an extremely rare tumor and few cases have been reported to date.</p> <p>Case presentation</p> <p>The authors report a case of gangliocytic paraganglioma verified by post-op pathology after pancreaticoduodenectomy for a tumor in the ampulla of Vater. The 56-year-old male patient concerned visited our emergency room with melena that started one week prior to hospitalization. The patient was diagnosed to have a tumor in the ampulla of Vater with bleeding on its surface. However post-op, he was diagnosed as having gangliocytic paraganglioma by immunohistochemistry.</p> <p>Conclusion</p> <p>This tumor has precise clinical implications, and if continuous follow up is conducted after careful diagnosis and surgical treatment, invasive major operations, such as, radical pancreaticoduodenectomy can be avoided.</p

An Antiproteinase lnhibits High Carbohydrate-Diet Induced Gallstone Formation in Hamsters

High carbohydrate(CHO) diet plays a role in pigment gallstone formation, though the mechanism is not yet clarified. We postulated that high CHO diet induces gallstone formation through a mechanism whereby high CHO diet poorly stimulates cholecystokinin(CCK) release and causes relative bile stasis. The purpose of our study was to examine whether camostat mesilate(camostat), oral antiproteinase increasing CCK release, inhibits gallstone formation from high CHO diet in hamsters. Fifty six hamsters were divided into 3 groups(G): I(n = 18) was fed normal rat chow(43% CHO), lI(n = 19) was fed a high CHO diet(65% CHO), III(n = 19) was fed 0.2% camostat high CHO diet. The animals were sacrificed after 8 weeks. Stones were checked grossly and gallbladder bile was analysed. Gallstones had developed in 11.1% of G-I, 84.2% of G-II, and 26.3% of GIII( p < 0.05: II vs III). Concentrations of cholesterol, phospholipid, calcium, bilirubin and bile acid were low in G-III. Pancreatic weight, reflecting chronic status of CCK level, of G-II1 was greater than other groups and that of G-II was smaller than that of G-I. In conclusion, camostat inhibits high CHO diet induced gallstone formation in hamsters and the possible mechanism is that camostat recovers the low CCK release by high CHO diet. This study suggests that high CHO diet is associated with pigment stone formation through the mechanism that high CHO diet causes poor CCK release

A systematic review of progress on hepatocellular carcinoma research over the past 30 years: a machine-learning-based bibliometric analysis

IntroductionResearch on hepatocellular carcinoma (HCC) has grown significantly, and researchers cannot access the vast amount of literature. This study aimed to explore the research progress in studying HCC over the past 30 years using a machine learning-based bibliometric analysis and to suggest future research directions.MethodsComprehensive research was conducted between 1991 and 2020 in the public version of the PubMed database using the MeSH term “hepatocellular carcinoma.” The complete records of the collected results were downloaded in Extensible Markup Language format, and the metadata of each publication, such as the publication year, the type of research, the corresponding author’s country, the title, the abstract, and the MeSH terms, were analyzed. We adopted a latent Dirichlet allocation topic modeling method on the Python platform to analyze the research topics of the scientific publications.ResultsIn the last 30 years, there has been significant and constant growth in the annual publications about HCC (annual percentage growth rate: 7.34%). Overall, 62,856 articles related to HCC from the past 30 years were searched and finally included in this study. Among the diagnosis-related terms, “Liver Cirrhosis” was the most studied. However, in the 2010s, “Biomarkers, Tumor” began to outpace “Liver Cirrhosis.” Regarding the treatment-related MeSH terms, “Hepatectomy” was the most studied; however, recent studies related to “Antineoplastic Agents” showed a tendency to supersede hepatectomy. Regarding basic research, the study of “Cell Lines, Tumors,’’ appeared after 2000 and has been the most studied among these terms.ConclusionThis was the first machine learning-based bibliometric study to analyze more than 60,000 publications about HCC over the past 30 years. Despite significant efforts in analyzing the literature on basic research, its connection with the clinical field is still lacking. Therefore, more efforts are needed to convert and apply basic research results to clinical treatment. Additionally, it was found that microRNAs have potential as diagnostic and therapeutic targets for HCC

Clinical Comparison of Distal Pancreatectomy with or without Splenectomy

The spleen may be preserved during distal pancreatectomy (DP) for benign disease. The aim of this study was to compare the perioperative and postoperative courses of patients with conventional DP and spleen-preserving distal pancreatectomy (SPDP) for benign lesions or tumors with low-grade malignant potential occurred at the body or tail of the pancreas. A retrospective analysis was performed for the hospital records of all the patients undergoing DP and SPDP between January 1995 and April 2006. One-hundred forty-three patients underwent DP and 37 patients underwent SPDP. There were no significant differences in age, sex, indications of operation, estimated blood loss, operative time, and postoperative hospital stay between the two groups. Pancreatic fistula occurred in 21 (13.3%) patients following DP and in 3 (8.1%) following SPDP without a significant difference (p=0.081). Portal vein thrombosis occurred in 4 patients after DP. Splenic infarction occurred in one patient after SPDP. Overwhelming postosplenectomy infection was observed in one patient after DP. SPDP can be achieved with no increase in complication rate, operative time, or length of postoperative hospitalization as compared to conventional DP. Additionally, it has the advantage of reducing the risk of overwhelming postsplenectomy infection and postoperative venous thrombosis

Clinicopathologic Features of Polypoid Lesions of the Gallbladder and Risk Factors of Gallbladder Cancer

It is difficult to differentiate benign and malignancy in polypoid lesions of the gallbladder (PLG) by solely depending on imaging studies. Therefore clinicopathologic features of benign and malignant polyps are compared in an attempt to identify the risk factors of malignant polypoid lesions. The medical records of 291 patients who were confirmed to have PLG through cholecystectomy were reviewed and analyzed for age, sex, symptom, associated gallstone, morphology of PLG, size of PLG, number of PLG, and preoperative tumor markers. Benign PLG was found in 256 patients (88.0%) and malignant PLG in 35 patients (12.0%). Compared with benign group, the malignant group were older (61.1 yr vs. 47.1 yr, P<0.001), more often accompanied with symptoms (62.9% vs. 28.9%, P<0.001). Malignant PLG tended to be sessile (60.0% vs. 10.5%, P<0.001), larger (28.0 mm vs. 8.6 mm, P<0.001) and single lesion (65.7% vs. 44.1%, P<0.016). Age over 60 yr (P=0.021, odds ratio [OR], 8.16), sessile morphology (P<0.001, OR, 7.70), and size over 10 mm (P=0.009, OR, 8.87) were identified as risk factors for malignant PLG. Careful decision making on therapeutic plans should be made with consideration of malignancy for patients over 60 yr, with sessile morphology of PLG, and with PLG size of over 10 mm

Primary Biliary Lymphoma Mimicking Cholangiocarcinoma: A Characteristic Feature of Discrepant CT and Direct Cholangiography Findings

Primary non-Hodgkin's lymphoma arising from the bile duct is extremely rare and the reported imaging features do not differ from those of cholangiocarcinoma of the bile duct. We report a case of a patient with extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALT), who presented with obstructive jaundice and describe the distinctive radiologic features that may suggest the correct preoperative diagnosis of primary lymphoma of the bile duct. Primary MALT lymphoma of the extrahepatic bile duct should be considered in the differential diagnosis when there is a mismatch in imaging findings on computed tomography or magnetic resonance imaging and cholangiography

서 론 췌장 신경내분비 종양은 최근 발생 및 진단 빈도가 높아진 것으로 보고되고 있으나[1,2] 전체 유병률이 10만명 당 1명 이하의 드문 질 환으로 임상양상 및 생존과 관련된 예후 인자는 정확히 알려져 있지 않다[3,4]. 지금까지의 국내외 보고들은 대부분 그 증례가 부족하여 일반화된 결론을 내리기에는 어려움이 있었다[5-7]. 췌장 신경내분비 종양은 임상양상에 따라 기능성과 비기능성 신 경내분비 종양으로 분류할 수 있는데, 현미경적으로는 감별이 어

Purpose: Pancreatic neuroendocrine tumors (PNETs) are rare neoplasms with reported incidence of &lt; 1 per 100,000 persons per year. PNETs are classified as functional or nonfunctional depending on their production of specific pancreatic endocrine hormones. This study presents the clinicopathologic characteristics and outcomes of PNETs experienced in a single institution

Clinical Efficacy of Organ-Preserving Pancreatectomy for Benign or Low-Grade Malignant Potential Lesion

The clinical usefulness of organ-preserving pancreatectomy is not well established due to technical difficulty and ambiguity of functional merit. The purpose of this study is to evaluate the clinical efficacy of organ-preserving pancreatectomy such as duodenum-preserving resection of the head of the pancreas (DPRHP), pancreatic head resection with segmental duodenectomy (PHRSD), central pancreatectomy (CP) and spleen-preserving distal pancreatectomy (SPDP). Between 1995 and 2007, the DPRHP were performed in 14 patients, the PHRSD in 16 patients, the CP in 13 patients, and the SPDP in 45 patients for preoperatively diagnosed benign lesions or tumors with low-grade malignant potential. The clinical outcomes including surgical details, postoperative complications and long-term functional outcomes were compared between organ-preserving pancreatectomy and conventional pancreatectomy group. Major postoperative complications constituted the following: bile duct stricture (7.1% [1/14]) in DPRHP, delayed gastric emptying (31.2% [5/16]) in PHRSD, pancreatic fistula (21.4% [3/14]) in CP. There were no significant differences in postoperative complications and long-term functional outcomes between two groups. Organ-preserving pancreatectomy is associated with tolerable postoperative complications, and good long-term outcome comparing to conventional pancreatectomy. Organ-preserving pancreatectomy could be alternative treatment for benign or low-grade malignant potential lesion of the pancreas or ampullary/parapapillary duodenum