Pancreatology (eBook)

Pancreatology 1
Heat Shock Proteins in Pancreatic Diseases 8
Heat Shock Proteins 8
HSPs, Beneficial or Harmful in Pancreatic Disease: A Matter of Perspective 8
HSPs in Pancreatitis 9
How Does HSP70 Protect Against Pancreatitis? 11
Summary 14
References 15
Cellular Stress in Acute Pancreatitis 16
Introduction 16
Cloning the Rat VMP1 Messenger RNA 17
VMP1 mRNA Expression During the Course of Acute Pancreatitis 17
Induction of VMP1 mRNA Expression in Stressed Kidney 18
VMP1 Expression Induced Vacuole Formation 18
What Is Autophagy ? 19
VMP1 Is an Autophagy-Involved Protein 20
VMP1 Expression Is Required for Extracellular-Stimuli-Induced Autophagy 21
VMP1 Is an Autophagosomal-Membrane Integrated Protein 21
VMP1 Is a Beclin 1 Binding Membrane Protein 22
VMP1–EGFP Targeted to Pancreatic Acinar Cells in the Pancreas of Transgenic Mice Triggers the Formation of LC3-Positive Vacuole 24
VMP1 Localizes in the Membrane of Pancreatitis-Induced Autophagic Vacuoles 24
Discussion and Conclusions 25
Acknowledgements 28
References 28
Systemic Inflammatory Effects of Acute Pancreatitis Effects of Lipid Mediators
Systemic Inflammatory Response in Pancreatitis 32
Lipids and Their Effect During Acute Pancreatitis 33
Regulatory Effects of Lipid Mediators 35
Antioxidant Mechanisms 35
References 38
Gemcitabine Changes the Gene Expression in Human Pancreatic Cancer Cells: Search for New Therapeutic Molecular Targets 40
Introduction 40
Materials and Methods 41
Results 41
Discussion 44
Acknowledgements 44
References 45
Cannabinoids as Potential Antitumoral Agents in Pancreatic Cancer 46
Pancreatic Cancer 46
Cannabinoids and Their Receptors 46
Antitumoral Activity of Cannabinoids 47
Antitumoral Activity of Cannabinoids in Pancreatic Cancer 48
Mechanism of Cannabinoid Antitumoral Action 48
Induction of Apoptosis 48
Inhibition of Tumor Angiogenesis 51
Cannabinoids as Potential Anticancer Agents 51
Future Perspectives 52
References 53
Pathogenesis of Chronic Pancreatitis with Special Emphasis on Genes1 57
Introduction 57
Epidemiology 58
PRSS1 Mutations in Chronic Pancreatitis 58
Clinical Characteristics 58
Hereditary Chronic Pancreatitis and Pancreatic Cancer 59
SPINK1 Mutations in Chronic Pancreatitis 59
CFTR Mutations in Chronic Pancreatitis 60
PRSS2 Mutations in Chronic Pancreatitis 60
Biochemical Analysis of Disease-Associated PRSS1 Mutations 61
R122H and Increased Trypsin Stability 61
N29I and Enhanced Trypsinogen Autoactivation 62
Animal Models 62
The Trypsinogen and SPINK1 Mutation Database 63
Further Pathogenetic Aspects of Chronic Pancreatitis 63
Understanding of Pathogenesis: Consequences for Treatment? 63
Future Perspectives 64
References 64
Bioecological Control of Disease, Especially Pancreatic Disease 69
Introduction 69
Instant Reaction: Narrow Therapeutic Window 69
Choice of Treatment Strategy 70
Choice of Treatment 71
Choice of Feeding System 71
Maintenance of Salivation and GI Secretion 72
Strict Blood Glucose Control 72
Generous Supply of Antioxidants 72
Control of Microbial Flora 73
The Concept of Synbiotics 74
Synbiotics in Chronic Liver Disease and Liver Transplantation 74
Synbiotics in General Surgery 75
Use of Synbiotics in Polytrauma 76
Use of Synbiotics in Acute Pancreatitis 76
Use of Synbiotics in Pancreatic Cancer Operations 77
Conclusions 77
References 78
The Role of Endoscopic Sphincterotomy in the Management of Acute Biliary Pancreatitis 80
Background 80
Patients and Methods 81
Results 81
Discussion 82
Conclusion 85
References 85
Indication for Surgery in Acute Necrotizing Pancreatitis 87
Introduction 87
Indications for Surgery 88
Infected Necrosis 88
Sterile Necrosis 88
Best Time Point of Surgery 88
Techniques of Open Pancreatic Necrosectomy 89
Necrosectomy/Debridement 89
Planned, Staged Relaparotomies with Repeated Lavage 90
Continuous Lavage of the Lesser Sac and Retroperitoneum 90
Closed Packing 91
Discussion 91
References 93
177658_1_EN_Index_Chapter_OnlinePDF.pdf 95