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World Journal of Gastroenterology Mar 2023Artificial intelligence (AI) has experienced substantial progress over the last ten years in many fields of application, including healthcare. In hepatology and... (Review)
Review
Artificial intelligence (AI) has experienced substantial progress over the last ten years in many fields of application, including healthcare. In hepatology and pancreatology, major attention to date has been paid to its application to the assisted or even automated interpretation of radiological images, where AI can generate accurate and reproducible imaging diagnosis, reducing the physicians' workload. AI can provide automatic or semi-automatic segmentation and registration of the liver and pancreatic glands and lesions. Furthermore, using radiomics, AI can introduce new quantitative information which is not visible to the human eye to radiological reports. AI has been applied in the detection and characterization of focal lesions and diffuse diseases of the liver and pancreas, such as neoplasms, chronic hepatic disease, or acute or chronic pancreatitis, among others. These solutions have been applied to different imaging techniques commonly used to diagnose liver and pancreatic diseases, such as ultrasound, endoscopic ultrasonography, computerized tomography (CT), magnetic resonance imaging, and positron emission tomography/CT. However, AI is also applied in this context to many other relevant steps involved in a comprehensive clinical scenario to manage a gastroenterological patient. AI can also be applied to choose the most convenient test prescription, to improve image quality or accelerate its acquisition, and to predict patient prognosis and treatment response. In this review, we summarize the current evidence on the application of AI to hepatic and pancreatic radiology, not only in regard to the interpretation of images, but also to all the steps involved in the radiological workflow in a broader sense. Lastly, we discuss the challenges and future directions of the clinical application of AI methods.
Topics: Humans; Artificial Intelligence; Liver Diseases; Magnetic Resonance Imaging; Pancreas
PubMed: 36998424
DOI: 10.3748/wjg.v29.i9.1427 -
Cirugia Y Cirujanos 2021Solid pseudopapillary tumor of the pancreas is a rare entity, more frequent in women between the 2 and 4 decades. The diagnosis is usually incidental and it can be...
Solid pseudopapillary tumor of the pancreas is a rare entity, more frequent in women between the 2 and 4 decades. The diagnosis is usually incidental and it can be reached by computed tomography or magnetic resonance imaging. Subsequent pathological confirmation is necessary for an adequate treatment. A retrospective study of six cases was carried out. All the patients were female, between 14 and 56 years of age, in which 50% the tumor were an incidental finding. We had three cases located in the head and three in the body of the pancreas. We performed three pancreaticoduodenectomies and three distal pancreatectomies with splenic preservation, without disease recurrence.
Topics: Female; Humans; Neoplasm Recurrence, Local; Pancreas; Pancreatectomy; Pancreatic Neoplasms; Retrospective Studies
PubMed: 33784288
DOI: 10.24875/CIRU.19001163 -
Japanese Journal of Clinical Oncology Aug 2023Undifferentiated carcinoma (UC) of the pancreas is a rare subtype of pancreatic cancer displaying no definitive direction of differentiation. UC has been reported as a... (Review)
Review
Undifferentiated carcinoma (UC) of the pancreas is a rare subtype of pancreatic cancer displaying no definitive direction of differentiation. UC has been reported as a highly aggressive malignant neoplasm, with a median overall survival of <1 year, except for several surgical series. On the other hand, UC tissue sometimes contains non-neoplastic osteoclast-like giant cells (OGCs), and such cases have been reported to have relatively longer survival. Thus, the World Health Organization (WHO) classification histologically distinguishes UC with OGCs (UCOGCs) from UC, and UCs were subclassified into three subtypes: anaplastic UC, sarcomatoid UC and carcinosarcoma. However, still less is known about UC due to its rarity, and such situations lead to further difficulties in treatment for UC. To date, only surgical resection can offer curative treatment for patients with UC, and no clear evidence for chemotherapy exists for them. However, a retrospective cohort study and case reports showed that relatively promising results paclitaxel-containing regimens for treatment of patients with unresectable UC. Furthermore, high programmed cell death protein 1 expression has been reported in sarcomatoid UCs and UCOGCs, and promising responses to anti-programmed death-ligand 1 therapy have been described in case reports of UCOGCs. Recent advances in chemotherapeutic agents and molecular technologies are opening up the possibilities for expanded treatments.
Topics: Humans; Retrospective Studies; Pancreatic Neoplasms; Carcinoma; Pancreas
PubMed: 37325968
DOI: 10.1093/jjco/hyad062 -
American Journal of Transplantation :... May 2022Pancreas transplantation improves and extends the life of patients with insulin-dependent diabetes. Pancreata from extended criteria donors have been increasingly used...
Pancreas transplantation improves and extends the life of patients with insulin-dependent diabetes. Pancreata from extended criteria donors have been increasingly used due to the scarcity of available grafts. Normothermic ex situ pancreas perfusion (NESPP) can keep grafts metabolically active, potentially allowing for assessment and organ repair, and could improve outcomes of marginal grafts. A novel NESPP technique was developed and tested. Porcine pancreata were removed after a short period of warm ischemia and subjected to 6 h of NESPP. Perfusion parameters, potential graft assessment markers and graft injury were measured. Next, pancreata subjected to 3 h of NESPP were transplanted and animals were followed for up to 3 days. Graft function and injury post-transplantation were evaluated. Using this novel system of perfusion, pancreata were perfused for an extended period of time with minimal edema. Histology at the end of perfusion showed intact islet cells with only mild signs of tissue injury. NESPP transplanted grafts showed immediate function after transplantation, with glucose levels in normal range. NESPP maintains a physiologic environment and excellent graft function without causing significant graft injury. Porcine pancreas transplantation is feasible and allows for in vivo graft assessment of pancreas function and injury after NESPP.
Topics: Animals; Humans; Organ Preservation; Pancreas; Pancreas Transplantation; Perfusion; Swine; Warm Ischemia
PubMed: 35258859
DOI: 10.1111/ajt.17019 -
Asian Journal of Surgery Jan 2023Pancreatic head cancer is a highly fatal disease. For now, surgery offers the only potential long-term cure albeit with a high risk of complications. However, the... (Review)
Review
Pancreatic head cancer is a highly fatal disease. For now, surgery offers the only potential long-term cure albeit with a high risk of complications. However, the progress of surgical technique during the past decade has resulted in 5-year survival approaching 30% after resection and adjuvant chemotherapy. This paper presents current data on the recommended extent of lymphadenectomy, the resection margin, on the definition of resectable and borderline resectable tumors and mesopancreas. Surgical techniques proposed to improve PD are presented: the artery first approach, the uncinate process first, the mesopancreas first approach, the triangle operation, periarterial divestment, and multiorgan resection.
Topics: Humans; Pancreaticoduodenectomy; Pancreas; Pancreatic Neoplasms; Margins of Excision
PubMed: 35680512
DOI: 10.1016/j.asjsur.2022.05.117 -
Frontiers in Endocrinology 2022Primary cilia as a signaling organelle have garnered recent attention as a regulator of pancreatic islet function. These rod-like sensors exist on all major islet... (Review)
Review
Primary cilia as a signaling organelle have garnered recent attention as a regulator of pancreatic islet function. These rod-like sensors exist on all major islet endocrine cell types and transduce a variety of external cues, while dysregulation of cilia function contributes to the development of diabetes. The complex role of islet primary cilia has been examined using genetic deletion targeting various components of cilia. In this review, we summarize experimental models for the study of islet cilia and current understanding of mechanisms of cilia regulation of islet hormone secretion. Consensus from these studies shows that pancreatic cilia perturbation can cause both endocrine and exocrine defects that are relevant to human disease. We discuss future research directions that would further elucidate cilia action in distinct groups of islet cells, including paracrine and juxtacrine regulation, GPCR signaling, and endocrine-exocrine crosstalk.
Topics: Animals; Cilia; Diabetes Mellitus; Disease Models, Animal; Insulin-Secreting Cells; Islets of Langerhans; Mice; Pancreas
PubMed: 35813631
DOI: 10.3389/fendo.2022.922983 -
Revista de Gastroenterologia de Mexico... 2022
Topics: Abdomen; Choristoma; Humans; Pancreas
PubMed: 35527198
DOI: 10.1016/j.rgmxen.2022.04.002 -
Nature Communications May 2024Cellular composition and anatomical organization influence normal and aberrant organ functions. Emerging spatial single-cell proteomic assays such as Image Mass...
Cellular composition and anatomical organization influence normal and aberrant organ functions. Emerging spatial single-cell proteomic assays such as Image Mass Cytometry (IMC) and Co-Detection by Indexing (CODEX) have facilitated the study of cellular composition and organization by enabling high-throughput measurement of cells and their localization directly in intact tissues. However, annotation of cell types and quantification of their relative localization in tissues remain challenging. To address these unmet needs for atlas-scale datasets like Human Pancreas Analysis Program (HPAP), we develop AnnoSpat (Annotator and Spatial Pattern Finder) that uses neural network and point process algorithms to automatically identify cell types and quantify cell-cell proximity relationships. Our study of data from IMC and CODEX shows the higher performance of AnnoSpat in rapid and accurate annotation of cell types compared to alternative approaches. Moreover, the application of AnnoSpat to type 1 diabetic, non-diabetic autoantibody-positive, and non-diabetic organ donor cohorts recapitulates known islet pathobiology and shows differential dynamics of pancreatic polypeptide (PP) cell abundance and CD8 T cells infiltration in islets during type 1 diabetes progression.
Topics: Humans; Proteomics; Diabetes Mellitus, Type 1; Algorithms; Pancreas; Islets of Langerhans; Single-Cell Analysis; Neural Networks, Computer; CD8-Positive T-Lymphocytes; Image Cytometry
PubMed: 38702321
DOI: 10.1038/s41467-024-47334-0 -
Biochimica Et Biophysica Acta. Reviews... Aug 2021The matrix stiffness of the extracellular matrix(ECM), which is the slow elastic force on cells, has gradually become investigated. And a higher stiffness could induce... (Review)
Review
The matrix stiffness of the extracellular matrix(ECM), which is the slow elastic force on cells, has gradually become investigated. And a higher stiffness could induce changes in cell biological behaviors and activation of internal signaling pathways. Imbalanced stiffness of ECM is associated with a number of diseases, including pancreatic disease. In this review, we discuss the components of the ECM and the increased stiffness caused by unbalanced ECM changes. Next, we describe how matrix stiffness transmits mechanical signals and what signaling pathways are altered within the cell in detail. Finally, we discuss the effect of ECM on the behavior of pancreatic diseases from the perspective of matrix stiffness.
Topics: Animals; Cell Communication; Cell-Matrix Junctions; Elasticity; Extracellular Matrix; Fibrosis; Humans; Mechanotransduction, Cellular; Pancreas; Pancreatic Diseases
PubMed: 34139274
DOI: 10.1016/j.bbcan.2021.188583 -
Molecular Metabolism Oct 2022Optogenetic modalities as well as optochemical and photopharmacological strategies, collectively termed optical methods, have revolutionized the control of cellular... (Review)
Review
BACKGROUND
Optogenetic modalities as well as optochemical and photopharmacological strategies, collectively termed optical methods, have revolutionized the control of cellular functions via light with great spatiotemporal precision. In comparison to the major advances in the photomodulation of signaling activities noted in neuroscience, similar applications to endocrine cells of the pancreas, particularly insulin-producing β-cells, have been limited. The availability of tools allowing light-mediated changes in the trafficking of ions such as K and Ca and signaling intermediates such as cyclic adenosine monophosphate (cAMP), renders β-cells and their glucose-stimulated insulin secretion (GSIS) amenable to optoengineering for drug-free control of blood sugar.
SCOPE OF REVIEW
The molecular circuit of the GSIS in β-cells is described with emphasis on intermediates which are targetable for optical intervention. Various pharmacological agents modifying the release of insulin are reviewed along with their documented side effects. These are contrasted with optical approaches, which have already been employed for engineering β-cell function or are considered for future such applications. Principal obstacles are also discussed as the implementation of optogenetics is pondered for tissue engineering and biology applications of the pancreas.
MAJOR CONCLUSIONS
Notable advances in optogenetic, optochemical and photopharmacological tools are rendering feasible the smart engineering of pancreatic cells and tissues with light-regulated function paving the way for novel solutions for addressing pancreatic pathologies including diabetes.
Topics: Glucose; Insulin; Insulin Secretion; Insulin-Secreting Cells; Pancreas
PubMed: 35863638
DOI: 10.1016/j.molmet.2022.101552