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Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

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World Journal of Gastroenterology 2008年第40期14卷 6171-6179页

作者： luis Aparisi luis sabater Juan Del-Olmo Juan Sastre Miguel-Angel Serra Ricardo Campello Daniel Bautista Abdalla Wassel José-Manuel Rodrigo Liver Unit Universitary Clinic Hospital Department of Surgery Universitary Clinic Hospital Department of Physiology University of Valencia Unit of Psiquiatry Servicio Valenciano de SaludValencia 46010Spain Department of Preventive Medicine Hospital Dr.Peset

AIM: To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology,after excluding any other ***: One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53),LC (n = 57),and asymptomatic alcoholic (n = 30).Clinical,biochemical and morphological characteristics,Child-Pugh index,indocyanine green test,and fecal pancreatic elastase-1 test were ***: In patients with cirrhosis,major clinical manifestations of CP such as pancreatic pain and steatorrhea,as well as imaging alterations of CP such as calcifications,duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases,and elastase-1 test was altered in only 7%,and severely altered in *** patients with CP,clinical characteristics of cirrhosis such as ascites,encephalopathy and gastrointestinal hemorrhage were present in one case,Child-Pugh grade > A in 5.7%,and altered indocyanine green test in 1.9% *** asymptomatic alcoholism,there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%,respectively,but other characteristics of cirrhosis or CP were *** inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic ***: There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology,but an inverse correlation between pancreatic and liver function *** findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis.

关键词： Alcoholic chronic pancreatitis Alcoholicliver cirrhosis Alcoholism Pancreatic function Hepaticfunction

Pathology handling of pancreatoduodenectomy specimens:Approaches and controversies

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World Journal of Gastrointestinal Oncology 2014年第9期6卷 351-359页

作者： María del Carmen Gómez-Mateo luis sabater-Ortí Antonio Ferrández-Izquierdo Department of Pathology Hospital Universitario Donostia Department of General and Gastroenterological Surgery Hospital Clínico ValenciaUniversity of Valencia Department of Pathology Hospital Clínico ValenciaUniversity of Valencia

Pancreatic cancer,with a 5% 5-year survival rate,is the fourth leading cause of cancer death in Western ***,only 20% of all patients benefit from surgical *** need to prolong survival has prompted pathologists to develop improved protocols to evaluate pancreatic specimens and their surgical ***,the new protocols will provide clinicians with more powerful prognostic indicators and accurate information to guide their therapeutic *** the availability of several guidelines for the handling and pathology reporting of duodenopancreatectomy specimens and their continual updating by expert pathologists,there is no consensus on basic issues such as surgical margins or the definition of incomplete excision(R1) of pancreatic ductal *** article reviews the problems and controversies that dealing with duodenopancreatectomy specimens pose to pathologists,the various terms used to define resection margins or infiltration,and *** reviewing the literature,including previous guidelines and based on our own experience,we present our protocol for the pathology handling of duodenopancreatectomy specimens.

关键词： Pancreatic ductal adenocarcinoma Duodenopancreatectomy specimens Resection margins Pathology protocols

Considerations on pancreatic exocrine function after pancreaticoduodenectomy

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World Journal of Gastrointestinal Oncology 2014年第9期6卷 325-329页

作者： Francisco José Morera-Ocon luis sabater-Orti Elena Muoz-Forner Jaime Pérez-Griera Joaquín Ortega-Serrano Department of General Surgery Hospital Clinico de Valencia46010 ValenciaSpain Clinical Analysis Laboratory Hospital Clinico de Valencia

The pancreaticoduodenectomy(PD) procedure may lead to pancreatic exocrine and endocrine *** are several types of reconstruction for this kind of ***(PG) was introduced to reduce the rate of postoperative pancreatic *** some randomized control trials have shown no differences regarding pancreatic leakage between PG and pancreaticojejunostomy(PJ),recently some reports reveal benefits from the PG over the *** surgeons concern about the performing of the PG and inactivation of pancreatic enzymes being in contact with the gastric juice,and the detrimental results over the exocrine pancreatic *** pancreatic exocrine function can be measured with direct and indirect *** tests have the highest sensitivity and specificity for detection of exocrine insufficiency but require tube *** the tubeless indirect tests,the van de Kamer stool fat analysis remains the standard to diagnose fat *** patient compliance and time consuming makes it not so suitable for its clinical *** immunoreactive elastase test is employed for screening of exocrine insufficiency,is not cumbersome,and has been used to study pancreatic function after *** analyze the FE1 levels in our patients after the PD with two types of reconstruction,PG and PJ,and we discuss some considerations about the pancreaticointestinal drainage method after pancreaticoduodenectomy.

关键词： Pancreaticoduodenectomy Pancreaticogastrostomy Pancreaticojejunostomy Pancreatic exocrine function Fecal elastase

Protein phosphatases and chromatin modifying complexes in the inflammatory cascade in acute pancreatitis

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2010年第3期1卷 75-80页

作者： Javier Escobar Javier Pereda Alessandro Arduini Juan Sastre Juan Sandoval luis Aparisi Gerardo López-Rodas luis sabater Department of Physiology University of Valencia 46100 Burjasot (Valencia) Spain Department of Biochemistry & Molecular Biology University of Valencia 46100 Burjasot (Valencia) Spain Laboratory of Pancreatic Function University Clinic Hospital 46010 Valencia Spain Department of Surgery University Clinic Hospital 46010 Valencia Spain

Acute pancreatitis is an inflammation of the pancreas that may lead to systemic inflammatory response syndrome and death due to multiple organ failure. Acinar cells, together with leukocytes, trigger the inflammatory cascade in response to local damage of the pancreas. Amplification of the inflammatory cascade requires up-regulation of proinflammatory cytokines and this process is mediated not only by nuclear factor κB but also by chromatinmodifying complexes and chromatin remodeling. Among the different families of histone acetyltransferases, the p300/CBP family seems to be particularly associated with the inflammatory process. cAMP activates gene expression via the cAMP-responsive element (CRE) and the transcription factor CRE-binding protein (CREB). CREB can be phosphorylated and activated by different kinases, such as protein kinase A and MAPK, and then it recruits the histone acetyltransferase co-activator CREB-binding protein (CBP) and its homologue p300. The recruitment of CBP/p300 and changes in the level of histone acetylation are required for transcription activation. Transcriptional repression is also a dynamic and essential mechanism of down-regulation of genes for resolution of inflammation, which seems to be mediated mainly by protein phosphatases (PP1, PP2A and MKP1) and histone deacetylases(HDACs) .Class HDACs are key transcriptional regulators whose activities are controlled via phosphorylationdependent nucleo/cytoplasmic shuttling. PP2A is responsible for dephosphorylation of class HDACs, triggeringnuclear localization and repression of target genes, whereas phosphorylation triggers cytoplasmic localization leading to activation of target genes. The potential benefit from treatment with phosphodiesterase inhibitors and histone deacetylase inhibitors is discussed.

关键词： Dual specificity protein phosphatases Acute pancreatitis Phosphodiesterase inhibitors Cytokines Histone acetylation Pentoxifylline PP2A Serine/threonine protein phosphatases

Comparative study measuring the dilatory effect of a mydriatic device(Mydriasert~) versus topical drops

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International Journal of Ophthalmology(English edition) 2013年第6期6卷 801-804页

作者： Manuel Saenz-de-Viteri Patricia Fernandez-Robredo Elisa de Nova Elvira Bonet-Farriol Alfonso L.sabater Javier Zarranz-Ventura Josemaria Caire luis M.Sadaba Angel Salinas-Alaman Alfredo Garcia-Layana Department of Ophthalmology University of Navarra

AIM:To compare the mydriatic efficacy of an ophthalmic insert(Mydriasert,MY)versus phenylephrine and tropicamide(PT)eye ***:Two controlled,prospective,randomized,single-blind studies were *** the first study,a total of 80 eyes from 40 outpatient-clinic patients were *** drops were applied to the right eye,and a MY device was inserted in the left eye for *** until maximal pupil dilation for each eye was then *** the second study,80 eyes from 80 patients undergoing cataract surgery were *** dilation was achieved using either PT drops three-times for one hour prior to surgery(40 patients),or a MY device was inserted one hour prior to surgery(40 patients).RESULTS:In the first study,MY achieved superior mydriasis compared to PT eye drops at 90min(9.04±1.33mm vs 8.78±1.37mm,P=0.012).However MY took longer than PT drops to achieve maximal dilation,and mydriasis was inferior in eyes with MY compared to PT drops at 30min(7.21±1.73mm vs 8.22±1.43mm,P<0.001),the two groups only becoming similar by 60min(8.85±1.44mm vs 8.71±1.27mm,P=0.236).In the second study,both MY and PT achieved similar levels of mydriasis at the beginning of surgery(8.75±0.76mm with MY vs 8.77±0.63mm with PT),and also at the end of surgery(7.96±1.06mm with MY vs 8.32±0.72mm with PT),with no significant difference between groups(P=0.08).MY was well tolerated and cardiovascular effects were not influenced by dilation ***:MY could be a safe and efficacious alternative for *** mydriatic effect of MY is as good as conventional PT eye drops after 60min,and is superior after *** also maintains good pupil dilation during cataract surgery.

关键词： Mydriasert~ mydriasis pupil dilation cataract surgery device