Showing papers by "Tadahiro Takada published in 2003"

Cytokine storm in acute pancreatitis: influence of inflammatory attack and arterial infusion therapy

Abstract: Purpose: This study was designed to clarify the change of the cytokine levels in acute pancreatitis (AP), and investigate the concern over the cytokine storm in AP with its course of inflammatory attack, as well as the effect of continuous arterial infusion therapy (CAI). Subjects and methods: Twenty-seven patients with AP were subjected during latest 3 years. The serum cytokines were determined before and after the treatment. Results: (1) In all subjects, high levels pro-inflammatory cytokines (IL-6, IL-8) were observed at the day of admission. However, after receiving the intensive treatments, IL-6, IL-8 levels tended to decline. (2) According to the severity of AP, the levels of IL-6 and IL-8 in severe cases were significantly higher than those in moderate and mild cases. (3) In five severe cases with infections, renewed rising of serum IL-6 was observed. (4) Abnormally heightened IL-10 (anti-inflammatory cytokine) was observed in complicated cases with infections. (5) The serum IL-6 was decreased immediately in severe cases after CAI, more rapidly than those without CAI. Conclusions: High levels of cytokines resumed in most cases of AP; when inflammation occurred, cytokine storm was suddenly observed. These molecules appear to be valuable markers of severity and effects of CAI.

Smallest cystic tumor, measuring 5 mm, was identified as an invasive adenocarcinoma among multiple intraductal papillary-mucinous tumors.

Abstract: We encountered a case of four cysts of intraductal papillary-mucinous tumor in the pancreas, a 25-mm diameter tumor, a 20-mm tumor, and a 10-mm tumor in the pancreatic body and tail, and a 5-mm diameter tumor in the uncinatus process, and the smallest diameter intraductal papillary-mucinous tumor (5 mm) was regarded as an invasive papillary adenocarcinoma, while the other three intraductal papillary-mucinous tumors were adenomas. A 63-year-old asymptomatic male was indicated of the presence of multiple pancreatic tumors by computed tomography during a physical examination. Endoscopic retrograde cholangiopancreatography revealed three cysts (25 mm, 20 mm, 10 mm diameter tumor) in the pancreatic body and tail, and one cyst 5 mm) in the uncinatus process. Cytologic examination of the pancreatic juice determined them as Class V. Based on a diagnosis of malignant intraductal papillary-mucinous tumors, he underwent distal pancreatectomy with removal of the uncinatus process. Pathologically, three cysts in the body and tail of the pancreas were found to be adenomas, but the 5-mm cyst in the uncinatus process was found to be an invasive intraductal papillary-mucinous tumor. The interstitium had been invaded by cancer, and the uncinatus process was the cancer positive surgical margin, and cystological examination of the pancreatic juice through repeated endoscopic retrograde cholangiopancreatography resulted in a class V, so the patient underwent a total pancreatectomy. When diagnosing intraductal papillary-mucinous tumor(s), there is the possibility of incorrectly differentiating between benignancy and malignancy when the diagnosis is based on cyst diameter, as is conventional.