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Plexiform neurofibroma of the cauda equina with follow-up of 10 years:A case report

World Journal of Clinical Cases 2022年第14期10卷 4519-4527页

作者： zilvinas chomanskis Raimondas Juskys Saulius Cepkus Justyna Dulko Vaiva Hendrixson Osvaldas Ruksenas Saulius Rocka Department of Neurology and Neurosurgery Institute of Clinical MedicineFaculty of MedicineVilnius UniversityVilnius 03104Lithuania Anatomy Histology and Anthropology DepartmentVilnius UniversityFaculty of MedicineVilnius 03104Lithuania Department of Neurosurgery Republican Vilnius University HospitalVilnius 04130Lithuania Faculty of Medicine Vilnius UniversityVilnius 03104Lithuania Institute of Biomedicine Faculty of MedicineVilnius UniversityVilnius 03104Lithuania Institute of Biosciences Life Sciences CentreVilnius UniversityVilnius 10257Lithuania

BACKGROUND Plexiform neurofibromas are extremely rarely found in the region of cauda equina and can pose a significant challenge in the diagnostic and management *** our knowledge,only 7 cases of cauda equina neurofibromatosis(CENF)have been reported *** SUMMARY We describe a case of a 55-year-old man with a 10 years history of progressive lower extremities weakness and bladder *** presenting,patient was misdiagnosed with idiopathic *** spine MRI revealed a tortuous tumorous masses in the cauda equina region,extending through the Th12-L4 *** patient underwent Th12-L3 Laminectomy with *** the operation,the most enlarged electroneurographically silent nerve root was resected,anticipating inadequate decompression if nerve root was *** patient’s neurological condition improved post-operatively,but urinary retention became the major *** provide a follow-up period of 10 *** this time,the patient’s condition progressively worsened despite extensive *** consequent MRI scans showed progressive enlargement of cauda equina roots and increasing lumbar stenosis,predominantly affecting L3-L4 *** the follow-up 8 years after the operation,the patient complained of worsening lower extremities sensorimotor function and neurogenic *** MRI revealed lumbar spine stenosis at the level of L3-L4,requiring further *** patient underwent a second surgery involving L4-L5 Laminectomy with duraplasty and L2-L5 transpedicular *** post-operative period was *** follow-up 18 mo after the second surgery revealed substantial improvement in patient’s *** CENF should be kept in mind during the differential diagnostic work-up for *** with an extensive decompression,duraplasty and primary spinal fixation represents a rational approach to achieve a sustained symptomatic improvement and s

关键词： Cauda equina Plexiform neurofibroma Neurofibromatosis type I Spine Spinal tumor Case report

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Value of adipokines in predicting the severity of acute pancreatitis:Comprehensive review

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World Journal of Gastroenterology 2012年第45期18卷 6620-6627页

作者： Andrius Karpavicius zilvinas Dambrauskas Audrius Sileikis Dalius Vitkus Kestutis Strupas Clinic of Gastroenterology NephrologyUrology and SurgeryFaculty of MedicineVilnius UniversityLT-01513 VilniusLithuania Center of Abdominal Surgery Vilnius University Hospital "Santariskiu klinikos"LT-08661 VilniusLithuania Department of Surgery Medical AcademyLithuanian University of Health SciencesLT-50009 KaunasLithuania Institute for Research of Digestive System Medical AcademyLithuanian University of Health SciencesLT-50009 KaunasLithuania Department of Physiology BiochemistryMicrobiologyand Laboratory MedicineFaculty of MedicineVilnius UniversityLT-01513 VilniusLithuania

AIM:To analyze the prognostic value of adipokines in predicting the course,complications and fatal outcome of acute pancreatitis(AP).METHODS:We performed the search of PubMed database and the systemic analysis of the literature for both experimental and human studies on prognostic value of adipokines in AP for period *** the papers that described the use of adipokines for prediction of severity and/or complications of AP were selected for further *** article had to contain information about the levels of measured adipokines,diagnosis and verification of AP,to specify presence of pancreatic necrosis,organ dysfunction and/or mortality *** the very beginning,study was carried out adhering to the PRISMA checklist and flowchart for systemic *** assess quality of all included human studies,the Quality Assessment of Diagnostic Accuracy Studies tool was *** of the high heterogeneity between the studies,it was decided to refrain from the statistical processing or meta-analysis of the available ***:Nine human and three experimental studies were included into *** experimental studies significant differences between leptin concentrations at 24 and 48 h in control,acute edematous and acute necrotizing pancreatitis groups were found(P = 0.027 and P < 0.001).In human studies significant differences between leptin and resitin concentrations in control and acute pancreatitis groups were found.1-3 d serum adiponectin threshold of 4.5 μg/mL correctly classified the severity of 81% of patients with *** threshold yielded a sensitivity of 70%,specificity 85%,positive predictive value 64%,negative predictive value88%(area under curve 0.75).Resistin and visfatin concentrations differ significantly between mild and severe acute pancreatitis groups,they correlate with severity of disease,need for interventions and *** adipokines are good markers for parapancreatic necrosis and the cut-off values of 11.9 ng/mL and 1.8 ng/

关键词：重症急性胰腺炎细胞因子严重程度预测值高脂肪急性坏死性胰腺炎审查价值

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Early recognition of abdominal compartment syndrome in patients with acute pancreatitis

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World Journal of Gastroenterology 2009年第6期15卷 717-721页

作者： zilvinas Dambrauskas Audrius Parseliunas Antanas Gulbinas Juozas Pundzius Giedrius Barauskas Laboratory for Research of Digestive System Institute for Biomedical Research and Department of SurgeryKaunas University of MedicineEiveniu Str.250009 KaunasLithuania Department of Surgery Kaunas University of MedicineEiveniu Str.250009 KaunasLithuania

AIM:To assess the value of widely used clinical scores in the early identification of acute pancreatitis(AP) patients who are likely to suffer from intra-abdominal hypertension(IAH)and abdominal compartment syndrome(ACS). METHODS:Patients(n=44)with AP recruited in this study were divided into two groups(ACS and non-ACS) according to intra-abdominal pressure(IAP)determined by indirect measurement using the transvesical route via Foley bladder *** admission and at regular intervals,the severity of the AP and presence of organ dysfunction were assessed utilizing different multifactorial prognostic systems:Glasgow-Imrie score,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE-Ⅱ)score,and Multiorgan Dysfunction Score(MODS).The diagnostic performance of scores predicting ACS development,cut-off values and specificity and sensitivity were established using receiver operating characteristic(ROC)curve analysis. RESULTS:The incidence of ACS in our study population was 19.35%.IAP at admission in the ACS group was 22.0(18.5-25.0)mmHg and 9.25(3.0-12.4)mmHg in the non-ACS group(P7;MODS>2 or Glasgow-Imrie score>3).

关键词：急性胰腺炎腹部间隔综合症腹部压力高血压器官功能紊乱

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How severe is moderately severe acute pancreatitis? Clinical validation of revised 2012 Atlanta Classification

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World Journal of Gastroenterology 2017年第43期23卷 7785-7790页

作者： Povilas Ignatavicius Aiste Gulla Karolis Cernauskis Giedrius Barauskas zilvinas Dambrauskas Department of Surgery Medical AcademyLithuanian University of Health Sciences Department of Surgery Georgetown University Hospital Department of Surgery Division of Vascular SurgeryVilnius UniversitySantariskiu Clinics

AIM To explore the outcomes and the appropriate treatment for patients with moderately severe acute pancreatitis(AP).METHODS Statistical analysis was performed on data from the prospectively collected database of 103 AP patients admitted to the Department of Surgery,Hospital of Lithuanian University of Health Sciences in 2008-2013. All patients were confirmed to have the diagnosis of AP during the first 24 h following admission. The severity of pancreatitis was assessed by MODS and APACHE Ⅱ scale. Clinical course was re-evaluated after 24,48 and 72 h. All patients were categorized into 3 groups based on Atlanta 2012 classification: Mild,moderately severe,and *** and management in moderately severe group were also compared to mild and severe cases according to Atlanta 1992 and 2012 *** Fifty-three-point four percent of patients had edematous while 46.6 % were diagnosed with necrotic AP. The most common cause of AP was alcohol(42.7%) followed by alimentary(26.2%),biliary(26.2%) and idiopathic(4.9%). Under Atlanta 1992 classification 56(54.4%) cases were classified as "mild" and 47(45.6%) as "severe". Using the revised classification(Atlanta 2012),the patient stratification was different: 49(47.6%) mild,27(26.2%) moderately severe and 27(26.2%) severe AP cases. The two severe groups(Atlanta 1992 and Revised Atlanta 2012) did not show statistically significant differences in clinical parameters,including ICU stay,need for interventional treatment,infected pancreatic necrosis or mortality rates. The moderately severe group of 27 patients(according to Atlanta 2012) had significantly better outcomes when compared to those 47 patients classified as severe form of AP(according to Atlanta 1992) with lower incidence of necrosis and sepsis,lower APACHE Ⅱ(P = 0.002) and MODS(P = 0.001) scores,shorter ICU stay,decreased need for interventional and surgical *** Study shows that Atlanta 2012 criteria are more accurate,reduce unnecessa

关键词：尖锐胰腺炎亚特兰大 1992 亚特兰大 2012 严厉层化治疗结果

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Current treatment strategies for patients with only peritoneal cytology positive stage IV gastric cancer

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World Journal of Clinical Cases 2021年第32期9卷 9711-9721页

作者： Augustinas Bausys zilvinas Gricius Laura Aniukstyte Martynas Luksta Klaudija Bickaite Rimantas Bausys Kestutis Strupas Department of Abdominal Surgery and Oncology National Cancer InstituteVilnius 08406Lithuania Clinic of Gastroenterology Nephrourology and SurgeryInstitute of Clinical MedicineFaculty of MedicineVilnius UniversityVilnius 03101Lithuania Faculty of Medicine Vilnius UniversityVilnius 08406Lithuania Clinic of Gastroenterology Nephrourology and SurgeryInstitute of Clinical MedicineVilnius UniversityVilnius 03101Lithuania

Gastric cancer(GC)is one of the most common malignancies worldwide and surgery remains the only potentially curative treatment option for *** a significant proportion of GC patients are found with distant metastases already at the initial *** dissemination is the most common site of *** peritoneal cytology(Cy1)is associated with poor long-term outcomes;thus,these patients are considered as stage IV even if macroscopic carcinomatosis is ***,there is no clear evidence for the most optimal treatment for this distinct subpopulation of the stage IV *** strategies vary from palliative chemotherapy to upfront *** comprehensive review summarized current evidence of different treatment strategies for Cy1 GC including roles of surgery,systemic and intraperitoneal chemotherapy.

关键词： Gastric cancer Positive peritoneal cytology Gastrectomy Systemic chemotherapy Intraperitoneal chemotherapy

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Different profiles of cytokine expression during mild and severe acute pancreatitis

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World Journal of Gastroenterology 2010年第15期16卷 1845-1853页

作者： zilvinas Dambrauskas Nathalia Giese Antanas Gulbinas Thomas Giese Pascal O Berberat Juozas Pundzius Giedrius Barauskas Helmut Friess Laboratory for Research of Digestive System Institute for Biomedical ResearchEiveniu Str. 2 50009 Kaunas Lithuania Department of Surgery Kaunas University of MedicineEiveniu Str. 2 50009 Kaunas Lithuania Department of Surgery Heidelberg UniversityIm Neuenheimer Feld 110D-69120 Heidelberg Germany Institute for Immunology Heidelberg UniversityIm Neuenheimer Feld 305D-69120 Heidelberg Germany Department of Surgery University of Technology MunichIsmaninger Str. 2281675 Munich Germany Department of Surgery Kaunas University of MedicineEiveniu Str. 250009 Kaunas Lithuania

AIM:To study secretion patterns of proand anti-in-flammatory cytokines, and activation of various cellular subsets of leukocytes in peripheral ***: We have conducted a prospective obser-vational study. One hundred and eight patients with a diagnosis of acute pancreatitis and onset of the disease within last 72 h were included in this study. The mRNA expression of 25 different types of cytokines in white blood cells was determined by quantitative real time polymerase chain reaction. Levels of 8 different cytokines in blood serum were measured by enzymelinked immunosorbent assay. Clinical data and cytokine expression results were subjected to statistical ***: Severe and necrotizing acute pancreatitis (AP) is characterized by the significant depletion of circulating lymphocytes. Severe acute pancreatitis is as-sociated with a typical systemic inflammatory response syndrome and over-expression of pro-inflammatory cy-tokines [interleukin (IL)-6, IL-8, macrophage migration inhibitory factor (MIF)]. Serum IL-6 and MIF concentra-tions are the best discriminators of severe and necrotiz-ing AP as well as possible fatal outcome during the early course of the disease. CONCLUSION: Deregulation of cellular immune sys-tem is a key event leading to severe and necrotizing AP. IL-6 and MIF could be used as early predictors of complications.

关键词： Acute pancreatitis Cytokines Prognostic factors

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Human antigen R mediated post-transcriptional regulation of inhibitors of apoptosis proteins in pancreatic cancer

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World Journal of Gastroenterology 2019年第2期25卷 205-219页

作者： Ausra Lukosiute-Urboniene Aldona Jasukaitiene Giedre Silkuniene Vidmantas Barauskas Antanas Gulbinas zilvinas Dambrauskas Institute for Digestive System Research Lithuanian University of Health Sciences Department of Pediatric Surgery Lithuanian University of Health Sciences Department of Surgery Lithuanian University ofHealth Sciences

AIM To determine the association of human antigen R(HuR) and inhibitors of apoptosis proteins(IAP1, IAP2) and prognosis in pancreatic *** Protein and mRNA expression levels of IAP1, IAP2 and HuR in pancreatic ductal adenocarcinoma(PDAC) were compared with normal pancreatic tissue. The correlations among IAP1/IAP2 and HuR as well as their respective correlations with clinicopathological parameters were analyzed. The Kaplan-Meier method and log-rank tests were used for survival analysis. Immunoprecipitation assay was performed to demonstrate HuR binding to IAP1, IAP2 mRNA. PANC1 cells were transfected with either anti-HuR siRNA or control siRNA for 72 h and quantitative reverse transcription polymerase chain reaction(RT-PCR), western blot analysis was carried *** RT-PCR analysis revealed that HuR, IAP1, IAP2 mRNA expression were accordingly 3.3-fold, 5.5-fold and 8.4 higher in the PDAC when compared to normal pancreas(P < 0.05). Expression of IAP1 was positively strongly correlated with HuR expression(P < 0.05, r = 0.783). Western blot analysis confirmed RTPCR results. High IAP1 expression, tumor resection status, T stage, lymph-node metastases, tumor differentiation grade, perineural and lymphatic invasion were identified as significant factors for shorter survival in PDAC patients(P < 0.05).Immunohistological analysis showed that HuR was mainly expressed in the ductal cancer cell's nucleus and less so in cytoplasm. RNA immunoprecipitation analysis confirmed IAP1 and IAP2 post-transcriptional regulation by HuR protein. Following siHuR transfection, IAP1 mRNA and protein levels were decreased, however IAP2 expression levels were *** HuR mediated overexpression of IAP1 significantly correlates with poor outcomes and early progression of pancreatic cancer. Further studies are needed to assess the underlying mechanisms.

关键词： Pancreatic cancer Inhibitors of apoptosis proteins Human antigen R Posttranscriptional regulation

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Narrow line between benefit and harm: Additivity of hyperthermia to cisplatin cytotoxicity in different gastrointestinal cancer cells

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World Journal of Gastroenterology 2018年第10期24卷 1072-1083页

作者： Vaidotas Cesna Arturas Sukovas Aldona Jasukaitiene Rima Naginiene Giedrius Barauskas zilvinas Dambrauskas Saulius Paskauskas Antanas Gulbinas Department of Surgery Lithuanian University of Health Sciences Department of Obstetrics and Gynecology Lithuanian University of Health Sciences Institute for Digestive Research Lithuanian University of Health Sciences Neuroscience Institute Lithuanian University of Health Sciences

AIM To investigate the response to hyperthermia and chemotherapy, analyzing apoptosis, cytotoxicity, and cisplatin concentration in different digestive system cancer *** AGS(gastric cancer cell line), Caco-2(colon cancer cell line) and T3M4(pancreatic cancer cell line) were treated by cisplatin and different temperature setting(37 ℃ to 45 ℃) either in isolation, or in combination. Treatment lasted for one hour. 48 h after the treatment viability was evaluated by MTT, cell apoptosis by Annexin V-PE and 7 ADD flow cytometry. Intracellular cisplatin concentration was measured immediately after the treatment, using mass spectrometry. Isobologram analysis was performed to evaluate the mathematical combined effect of temperature and *** AGS cells were the most sensitive to isolated application of hyperthermia. Hyperthermia, in addition to cisplatin treatment, did not provoke a synergistic effect at intervals from 37 ℃ to 41 ℃ in neither cancer cell line. However, a temperature of 43 ℃ enhanced cisplatin cytotoxicity for Caco-2 cells. Moreover, isobologram analysis revealed mathematical antagonistic effects of cisplatin and temperature combined treatment in AGS cells; variations between synergistic, additive, and antagonistic effects in Caco-2 cells; and additive and antagonistic effects in T3 M4 cells. Combined treatment enhanced initiation of cell apoptosis in AGS, Caco-2, and T3 M4 cells by 61%, 20%, and 19% respectively. The increase of intracellular cisplatin concentration was observed at 43 ℃ by 30%, 20%, and 18% in AGS, Caco-2, and T3 M4 cells, *** In addition to cisplatin, hyperthermia up to 43 ℃ does not affect the viability of cancer cells in a synergistic manner.

关键词： hyperthermal intraperitoneal chemotherapy Cisplatin Hyperthermia Isobolograms Gastric cancer Pancreatic cancer Colon cancer

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zilvinas Kempinas个展

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现代装饰 2016年第11期 22-23页

作者： zilvinas Kempinas Ikon Stuart Whipps 彭佳

该展览于英国Ikon画廊展出,来自于常驻纽约的立陶宛艺术家zilvinas Kempinas。这次展出包括一系列装置,把自然现象进行了具象化的表达,比如光影的变幻、空气的循环等等,重在游客与动力作品的互动。Kempinas的作品都是来源于生活中极其... 详细信息

该展览于英国Ikon画廊展出,来自于常驻纽约的立陶宛艺术家zilvinas Kempinas。这次展出包括一系列装置,把自然现象进行了具象化的表达,比如光影的变幻、空气的循环等等,重在游客与动力作品的互动。Kempinas的作品都是来源于生活中极其平常的物品和材料,而其最为出名的就是利用录像带创作出的装置作品。这种材料之所以吸引设计师不仅因为其流动的光影所产生的抽象意义,还因其与众不同的物理特性。

关键词：装置作品系列装置具象化视觉体验超现实光泽度视觉信息大量生产空间布局令人

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HuR mediated post-transcriptional regulation as a new potential adjuvant therapeutic target in chemotherapy for pancreatic cancer

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World Journal of Gastroenterology 2015年第46期21卷 13004-13019页

作者： Aldona Jakstaite Aurelija Maziukiene Giedre Silkuniene Kristina Kmieliute Antanas Gulbinas zilvinas Dambrauskas Institute for Digestive System Research Lithuanian University of Health Sciences Department of Surgery Lithuanian University of Health Sciences

AIM: To investigate the expression of Hu R in pancreatic ductal adenocarcinoma(PDA) and to assess the effects of Hu R silencing on the expression of cyclooxygenase-2(COX-2) and heme oxygenase-1(HO-1) and the in vitro response to gemcitabine(GEM) treatment in pancreatic cell ***: We compared the expression of Hu R,COX-2,and HO-1 in PDA and normal pancreatic tissueusing quantitative reverse transcription polymerase chain reaction(q RT-PCR) and western blot. In addition,the Hu R,COX-2 and HO-1 were analyzed in four types of cancer cell lines(Mia Paca2,Su.86.86,Capan-1,and Capan-2) with and without GEM treatment. Immunocytofluorescence analysis was used to investigate Hu R localization in cells. Cell viability and response to GEM after Hu R silencing were determined with the 3-(4,5-dimethylthiazol-2-Yl)-2,5-diphenyltetrazolium bromide test and the crystal violet clonogenic assay,respectively. To measure apoptosis,activation of caspases 3/7 was evaluated using immunofluorescence. RESULTS: In PDA tissue obtained from patients not treated with GEM,Hu R m RNA expression was 3.2 times lower(P < 0.05) and COX-2 and HO-1 m RNAexpression was 2.3-fold and 7.2-fold higher(P < 0.05),respectively,than normal pancreatic tissue(from organ donor). q RT-PCR analysis showed that Hu R,COX-2,and HO-1 m RNA were overexpressed in all cancer cell lines treated with the half maximal inhibitory concentration(IC50) dose of GEM compared with control cells(P < 0.05). Western blot analysis revealed that COX-2 and HO-1 levels were significantly decreased in cancer cells after Hu R silencing. Furthermore,HuR silencing in creased the response to GEM treatmentand decreased cell viability by 11.6%-53.7% compared to control cell lines. Caspases 3 and 7 were activated after Hu R silencing and GEM treatment in all pancreatic cancer cell lines. In comparison,treatment with GEM alone did not activate caspases 3 and 7 in the same cell lines. CONCLUSION: Hu R mediated post-transcriptional upregulati

关键词： HuR Pancreatic cancer Chemotherapy Cyclooxygenase-

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