Pancreatic exocrine insufficiency occurs more frequently in diabetic patients than in controls. Diabetic individuals with excess weight (BMI >25) may be at increased risk for underlying exocrine pancreatic insufficiency.
MMP1 and MMP2 may protect against prostate cancer development and MMP9 may be related to higher risk. In contrast, MMP9 polymorphism was associated with a lower Gleason score and MMP2 polymorphism was associated with nonorgan confined disease.
The acquisition of a castration-resistant prostate cancer phenotype by prostate cancer cells is the alteration that has the worst prognosis for patients. The aim of this study was to evaluate the role of the microRNAs-23b/-27b as well as the possible CCNG1 target gene in tissue samples from patients with localized prostate cancer that progressed to castrationresistant prostate cancer and in a castration-resistant prostate cancer cell line (PC-3). The microRNAs and target gene expression levels of the surgical specimens were analyzed by quantitative real-time polymerase chain reaction. The prostate cancer cell line, PC-3, was transfected with pre-miR-23b, pre-miR-27b, and their respective controls using Lipofectamine RNAiMAX and exposed or not to flutamide. After transfections, expression levels of both the microRNAs and the gene, CCNG1, were analyzed by quantitative real-time polymerase chain reaction. The apoptosis and cell cycle assays were performed on the mini MUSE cytometer. MicroRNAs-23b/-27b were underexpressed in surgical specimens of prostate cancer; however, their target gene, CCNG1, was overexpressed in 69% of the cases. After transfection with the microRNAs-23b/-27b and flutamide, we observed a reduction in gene expression compared with cells that were treated only with microRNAs or only with flutamide. In the apoptosis assay, we demonstrated cell sensitization following transfection with microRNAs-23b/-27b and potentiation when co-administered with flutamide. The number of cells in apoptosis was almost three times higher with the simultaneous treatments (miR + flutamide) compared with the control (p \ 0.05). In the cell cycle assay, only flutamide treatment showed better results; a higher number of cells were found in the G0-G1 phase, and a lower percentage of cells completed the final phase of the cycle (p \ 0.05). We conclude that microRNAs-23b/-27b are downexpressed in prostate cancer, and their target gene, CCNG1, is overexpressed. We postulated that microRNAs-23b/-27b sensitize the PC-3 cell line and that after the addition of flutamide in the apoptosis assay, we would observe synergism in the treatments between miR and flutamide. In the cell cycle assay, the use of flutamide was sufficient to decrease the number of cells in mitosis. Therefore, we postulate that microRNAs, along with other drugs, may become very useful therapeutic tools in the treatment of castration-resistant prostate cancer.
Sixteen cases of juxta-ampullar duodenal diverticula are presented. These diverticula had an obvious participation in bilio-pancreatic pathology, such as gallstones, ductal stones and pancreatitis. Four patients had been cholecystectomized and two gastrectomized in other Services. All patients were operated on combined operations, 10 undergoing cholecystectomy, 13 choledocholithotomy and 15 papillosphincteroplasty. In 10 patients the diverticulum was removed. During the postoperative follow-up, 5 patients who did not have the diverticulum removed, presented recurrence of bilio-pancreatic symptoms and had to undergo reoperation. It is concluded that juxta-ampullar diverticula constitute a pathology that may determine involvement of the terminal parts of the pancreatic ducts. The best surgical procedure is represented by removal of the diverticulum associated to papillosphincteroplasty. When it is not possible to remove the diverticulum for technical reasons, and the bile duct being dilated, there is a recurrence of symptoms in the biliary tract. In these cases, the methods of choice are biliary-digestive derivations (Roux-en-Y or choledocho-duodenal anastomosis in gastrectomized patients, second Billroth II).
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