PTBD treatment is an effective therapy. PTBD treatment and additional CT-guided drainage of bilomas helped to reduce intraabdominal inflammation, as shown by reduction of inflammation parameters.

Adjustable gastric banding is a well-established procedure for the treatment of morbid obesity. We present a 62-year-old female who experienced the rare complication of intragastric band perforation due to a gastric adenocarcinoma localized at the site of gastric banding, 10 years after insertion of the band.

Backg round: Previous studies described a hem odynamic insta bility in the pote nt ial orga n don or which has clinical relevance for cardiac t ransplantation. The possible pathophysiological link between altered loadin g conditio ns, coronary perfu sion. and ca rdiac function afte r brain death has not been investiga te d yet. Ther efore this st udy was und ert aken to invest igat e t he ro le of corona ry perfu sion changes durin g brain death in cardiac dysfunction. Methods : Dogs o n card iopulmonary bypass prov ided isovolumetr ic left-ventricular (LV) cont ract ions. By protoco l, coronary perfu sion pressure was kept at th e leve l of mean aort ic pressure. LV pressure, LV dP/dt , the slope of end-systo lic pressure-volume relationship (Em.l K) ' coronary blood flow (CBF), and myocardial oxyge n consumpt ion (MV0 2) were measured. Brain death was induced by a subdurally placed balloon-catheter. Res ults: Induct ion of brain death led to a transient hyperd ynamic response with a significant increase of ao rt ic and LV pressure, dP/dt, Em.l K ' CBF, and MV0 2 • Thereafter, ao rt ic pressure and, parallelly, LV pressure, dP/dt, Em.l K ' CBF, and MV0 2 decreased significantly. However, if coronary perfusion pressure was decoupled from aortic pressure and elevate d to pre-brain death level, CSF and myocardial cont ract ility were restored to baseline level. Concluslon: The impairment of coro nary blood flow may cont ribute to decreased contra ctility afte r brain death.

Zusammenfassung ▼Ziel: Beurteilung der diagnostischen Eignung der Dual-Energy (DE) Perfusions-CT zur Differenzierung von postoperativen Weichgewebeformationen und Tumorrezidiven nach potentiell kurativer Pankreaskarzinomresektion. Material und Methoden: 24 Patienten nach potentiell kurativer Resektion eines Pankreaskarzinoms, die im Rahmen der regulären konventionellen Nachsorge-CT unklare postoperative Weichgewebeformationen aufwiesen, wurden prospektiv eingeschlossen. Die Untersuchung erfolgte an einem 64-Zeilen Dual-Source-CT mittels einer dynamischen Sequenz aus 34 DE-Akquisitionen alle 1,5 s (80 ml iodhaltiges Kontrastmittel, 370 mg/ml, Fluss 5 ml/s). DE Perfusions-Bilddatensätze linear gewichteter 120kVp-äquivalenter Mischbilder wurden mit einer Body-Perfusions CT-Applikation (CT Body Perfusion, Siemens Medical Solutions, Germany) zur Berechnung von Blutfluss, Permeabilität und Blutvolumen ausgewertet. Die Diagnose wurde mittels histologischer Sicherung (n = 4) bzw. durch weitere, reguläre Verlaufskontrollen bestätigt. Ergebnisse: Bei 15 Patienten wurden Rezidive eines Pankreaskarzinoms diagnostiziert, 9 Patienten zeigten unspezifische Weichgewebeformationen. Der auf Basis gewichteter, 120kVp-äquivalenter DE Perfusions-Bilddatensätze bestimmte Blutfluss in Rezidiven tendierte zu niedrigeren Werten mit 16,6 ml/100 ml/min vs. 24,7 ml/100 ml/min im Vergleich zu den unspezifischen Weichgewebeformationen, wenn auch nicht signifikant (n.s., p = 0,06, Signifikanzniveau 0,05). Permeabilität und Blutvolumen der Rezidive waren nur geringfügig niedriger (n.s.). Schlussfolgerung: Die DE Perfusions-CT ist eine vielversprechende Methode der funktionellen Bildgebung und scheint für die Diagnostik in der Nachsorge nach Pankreaskarzinomresektion geeignet. Bislang ist nur ein Trend zu niedrigeren Perfusionswerten in Rezidiven im Vergleich zu unspezifiAbstract ▼ Purpose: To evaluate the diagnostic performance of dual energy (DE) perfusion-CT for the differentiation between postoperative soft-tissue formation and tumor recurrence in patients after potentially curative pancreatic cancer resection. Material and methods: 24 patients with postoperative soft-tissue formation in the conventional regular follow-up CT acquisition after pancreatic cancer resection with curative intent were included prospectively. They were examined with a 64-row dual-source CT using a dynamic sequence of 34 DE acquisitions every 1.5 s (80 ml of iodinated contrast material, 370 mg/ml, flow rate 5 ml/s). Weighted average (linearly blended M0.5) 120kVp-equivalent dual-energy perfusion image data sets were evaluated with a body-perfusion CT tool (see above) for estimating blood flow, permeability, and blood volume. Diagnosis was confirmed by histological study (n = 4) and by regular follow-up. Results: Final diagnosis was local recurrence of pancreatic cancer in 15 patients and unspecific postoperative tissue formation in 9 patients. The blood-flow values for recurrence tissue trended to be lower compared to postoperative tissue formation with 16.6 ml/100...

Transforming Growth Factor Beta (TGF$) signaling plays dual roles in pancreatic tumor development. In vivo loss of either Smad4 or Tgfbr2 promotes pancreatic adenocarcinoma in mice expressing mutant Kras. Conversely, pharmacologically-induced reduction in Tgfbr1 kinase activity attenuates growth and metastasis of Panc1 cells orthotopically injected into mouse pancreas. To dissect the role of TGF-$ signaling in pancreatic cancer development, we crossed Elastase-Kras (EL-Kras) mice with Tgfbr1 heterozygous knockout mice to generate EL-Kras/Tgfbr1 +/j mice. These EL-Kras/Tgfbr1 +/j mice and EL-Kras/Tgfbr1 +/+ mice from the same litter, as well as the EL-Kras F1 mice (FVB crossed one generation into C57BL/6), were euthanized at 6Y9 months of age to compare the incidence, frequency, and size of precancerous lesions in the pancreas. We observed a 65% decrease in the incidence of precancerous lesions in EL-Kras/Tgfbr1 +/j mice as compared to 100% of EL-Kras F1 mice at six to eight months of age. The frequency of precancerous lesions was also reduced from 11 pre-cancerous lesions per animal to 3, representing a 3.5-fold decrease. More significantly, the levels of fibrosis around pre-cancerous lesions and normal-appearing parenchyma were dramatically reduced in EL-Kras/Tgfbr1 +/j mice. In addition, EL-Kras/Tgfbr1 +/j mice showed reduced lipoatrophy and lymphocytic infiltration, compared to their EL-Kras/Tgfbr1 +/+ counterparts. It has been recently shown that Pdx1-Cre/LSL-Kras mice with hetero-or homozygous loss of either Smad4 or Tgfbr2 alleles develop pancreatic adenocarcinoma within 2Y4 months of age. Likewise, previous findings in EL-Kras/MT-Tgfbr2-DNR mice in two distinct strains demonstrated a 2Y3 fold increase in mutant Kras-induced precancerous lesions in the pancreas. In our system, EL-Kras/Tgfbr1 heterozygous null mice have a significantly reduced propensity of developing carcinoma in situ and accompanying phenotypes. In particular, there is a dramatic reduction in focal and diffuse fibrosis and less lymphocytic infiltration. These findings correlate with TGF-$ signals that increase ECM deposition and augment immune responses and strongly suggest that Tgfbr1 haploinsufficiency may have a protective role with respect to pancreatic cancer development.Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.anastomotic failures were observed in the dogs treated by bFGF-GH. Histological observations of this group revealed abundant granulation tissues. Treatment with bFGF-GH significantly increased the breaking strength and MVD over the levels measured in the control group (P G 0.01). Conclusions: bFGF-GH accelerates healing of pancreaticojejunal anastomosis during the early postoperative period. Basic FGF-GH may show promise as a new technique for preventing anastomotic failure of pancreaticojejunostomy.