The pancreas is a vital organ which has both endocrine and exocrine functions and plays an essential role in food digestion and glucose metabolism. Pancreatic structure and function undergo a series of changes with aging and senescence. Pancreatic exocrine and endocrine function gradually change, which may lead to conditions such as dyspepsia and diabetes mellitus. Hence, clinicians need to be familiar with the characteristics of pancreatic senescence. This article reviews the manifestations of pancreatic senescence and its significance for clinical practice.
Objective To investigate the morphological changes with age in the pancreases of healthy individuals undergoing magnetic resonance imaging (MRI). Methods The participants were selected from adults who were undergoing physical examinations from January 2017 to September 2020 at Huadong Hospital. They were divided according to age, as broken down by decades into seven groups ranging from 20 to 29 years to ≥80 years of age. There were 30 to 35 cases for each decade. They were then divided into a young and middle‐aged group (<60 years of age) and an elderly group (≥60 years of age). The morphological characteristics of the pancreases of each participant in the group were measured on magnetic resonance images. The characteristics included the pancreatic anteroposterior diameters and volumes. The relationships between the anteroposterior diameters of the pancreatic head, body, and tail and pancreatic volume and age were analyzed. Results A total of 226 magnetic resonance images from 112 (49.56%) men and 114 (50.44%) women, aged 22–93 (54.68 ± 19.52) years. The age ranges of the seven groups consisted of the following: 20–29 years ( n = 33), 30–39 years ( n = 32), 40–49 years ( n = 32), 50–59 years ( n = 31), 60–69 years ( n = 35), 70–79 years ( n = 33) and ≥80 years ( n = 30). The age range and numbers of patients in the young and middle‐aged group was 22–59 (40.09 ± 10.88) years ( n = 128) and in the elderly group was 60–93 (73.74 ± 8.99) years ( n = 98). The MRI findings characteristic of aging included pancreatic atrophy (especially of the pancreatic tail), pancreatic lobulation, uneven signal intensity, fatty degeneration, and widening of the main pancreatic duct. The respective anteroposterior diameters of the pancreatic head, body, and tail and the pancreatic volumes peaked at 30 to 39 years as follows: 28.03 ± 4.45 mm, 24.10 ± 4.27 mm, 24.57 ± 4.94 mm, 98.54 ± 26.56 cm 3 ; and then gradually decreased to 19.05 ± 3.59 mm, 16.00 ± 3.81 mm, 13.83 ± 3.39 mm, 45.02 ± 9.15 cm 3 at ≥80 years, for respective decreases of 32.03%, 33.60%, 43.71%, and 54.31%. The respective anteroposterior diameters of the pancreatic head, body, tail, and pancreatic volume in the elderly patients were 21.45 ± 4.15 mm, 18.14 ± 4.09 mm, 16.81 ± 4.37 mm, and 59.02 ± 21.44 cm 3 , which were significantly smaller than the respective corresponding measurements in the young and middle‐aged patients (26.09 ± 4.40 mm, 22.30 ± 4.42 mm, 22.08 ± 4.53 mm, and 88.32 ± 23.92 cm 3 ). The differences were statistically significant (t = 8.06, 7.24, 8.79, 9.54, respectively, p < 0.001). The a...
Posterior reversible encephalopathy syndrome (PRES) is a rare, reversible neurological disease that is frequently associated with the use of targeted therapy agents. In this case study, we examine the development of posterior reversible encephalopathy syndrome (PRES) in a 44-year-old woman with metastatic colon cancer following 1 month of treatment with the vascular endothelial growth factor receptor (VEGFR) inhibitor, fruquintinib. The occurrence of PRES after 1 month of VEGFR inhibitor administration is a common phenomenon. However, it is noteworthy that this is the first reported case of PRES associated with fruquintinib. The patient’s neurological function improved upon discontinuing the drug for a week, but worsening was observed following a lower-dose fruquintinib treatment. This patient’s experience highlights the potential for neurological deterioration in those treated with fruquintinib, prompting physicians to consider the possibility of PRES. Notably, this may be the first reported case linking fruquintinib to the syndrome, underscoring the importance of recognizing the association between PRES and fruquintinib.
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