Pancreatic cancer has an unfavorable prognosis; surgery and chemotherapy at present have only limited value. To improve the prognosis of pancreatic cancer, effective non-surgical therapy is necessary. NF-κ κ κ κB is reported to be related to resistance to apoptosis, but its role in chemosensitivity remains controversial. We ex- esistance of tumors to chemotherapy is a common clinical problem in human cancer. Pancreatic cancer is considered to be one of the malignancies most resistant to therapy. Overall 5-year survival rate is only 8.1% in Japan 1) . Despite many advances in the diagnosis of pancreatic cancer, only a small minority of patients are candidates for curative surgical resection. However, even for resected patients, the 5-year survival rate is only 18.9%, 1) because of post operative recurrence. Accordingly, to improve the prognosis of pancreatic cancer, there is an urgent need to develop effective non-surgical treatment for this disease. Radiotherapy for pancreatic cancer has limited value in clinical practice, as does chemotherapy, due to the lack of any individual agent with potent activity.
Abstract. Liver damage with hyperbilirubinemia during regeneration of the small liver is the major hurdle to expand the indications of adult living donor liver transplantation. We performed a large-scale gene expression analysis of the regenerating liver after a 90% hepatectomy in rats, and analyzed the changes in the gene expression patterns related to the ATP-binding cassette (ABC) transporters. RNAs were prepared from 3 rat livers at 0, 24, 72 and 168 h after a 90% hepatectomy. The gene expression profile was analyzed by the Rat Genome 230 2.0 array with special references to the ABC transporters. Among 31,042 probes, 1,587 reported genes were identified as either upregulated or downregulated more than 2-fold. Among 20 ABC transporter genes, multidrug resistance protein (MRP) 2 and organic anion transporting polypeptide (OATP) 1 were significantly downregulated, while MRP1 and MRP3 tended to be expressed. These genetic changes were confirmed by real-time PCR. A microarray analysis demonstrated not only an extensive gene expression profile in the regenerating liver but more specific molecular events related to bilirubin transport at the same time. Changes in the expression pattern of the ABC transporters, therefore, seem to be the key event in liver failure during liver regeneration.
2)An 82-year-old woman was referred to the department of gastrointestinal medicine at our hospital for further examination after a medical check-up revealed a positive fecal occult blood test, and lower endoscopy conducted at a nearby clinic showed a tumor in the terminal ileum. Abdominal computed tomography (CT) showed a tumor on the left side of the abdomen in addition to the ileal tumor, and the patient was admitted for tests. Frequent melena and progressive anemia were observed on the day after admission, but due to difficulty with endoscopic hemostasis of bleeding from the ileal tumor, the patient was referred to our department for surgery. Tumors were palpated in the terminal ileum and jejunum, and because the neighboring mesenteric lymph nodes had become enlarged, malignant lymphoma with multiple lesions was suspected, and the small intestine was partially resected in two locations. The resected samples revealed a total of 7 tumorous lesions (6 in the jejunum and 1 in the ileum). The histopathological diagnosis was carcinoid tumor of the small intestine for all lesions, but lymph node metastasis could not be determined. Octreotide was administered as adjuvant therapy, and relapse-free survival has been achieved for 3 years. The present case of multiple carcinoid tumors of the small intestine, which are extremely rare in Japan, is reported in the context of the literature. Key words:carcinoid tumor of the small intestine,multiple,melena
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