Neostigmine® Improves Pancreatic Duct Visualization in Magnetic Resonance Cholangiopancreatography and Could Be a Cheap Alternative for Secretin

Background:To determine the effect of intramuscular administration of Neostigmine^® on the visualization of the pancreatic duct on magnetic resonance cholangiopancreatography in patients with recurrent acute pancreatitis or abdominal pain.Methods:We reviewed patients undergoing magnetic resonance cholangiopancreatography followed by a Neostigmine^®-enhanced magnetic resonance cholangiopancreatography. Patients with a history of recurrent acute pancreatitis or abdominal pain who had a magnetic resonance cholangiopancreatography where the pancreatic duct was not entirely seen, were selected to undergo a second magnetic resonance cholangiopancreatography 40 minutes after 0.5 mg Neostigmine^®. Images were analyzed by 2 radiologists. The diameter of the pancreatic duct was measured in the head, body, and tail of the pancreas on the baseline images and after Neostigmine^®.Results:Ten patients were included, with a median age of 33 years (range 15-61). The maximum diameter of the pancreatic duct increased significantly after Neostigmine^® administration in all patients, from 1.84 ± 0.98 to 3.41 ± 1.27 mm in the head, 1.34 ± 0.42 mm to 2.5 ± 0.49 mm in the body and 0.72 ± 0.52 mm to 1.78 ± 0.43 mm in the tail (mean ± SD, P < .0001). Neostigmine^® helped to provide better detail of the pancreatic duct anatomy in 4 patients. In 2 patients we confirmed pancreas divisum, in another the Santorini duct was not seen on the baseline images but it was clearly visualized after Neostigmine^®, and in the fourth patient, Neostigmine^® improved visualization of multiple pancreatic duct stenosis.Conclusion:Neostigmine^®-magnetic resonance cholangiopancreatography significantly increases the diameter of the pancreatic duct, allowing an accurate morphological evaluation. It could be a cheap alternative to secretin, which is expensive and hardly available.     

Randomized phase II trial of survivin 2B peptide vaccination for patients with HLA‐A24‐positive pancreatic adenocarcinoma

The prognosis of advanced pancreatic adenocarcinoma is still extremely poor. This study sought to determine the efficacy of, and immunological response to, peptide vaccination therapy in patients with this disease. In this multicenter randomized phase II study, patients with advanced pancreatic adenocarcinoma after gemcitabine and/or tegafur/gimeracil/oteracil were randomly assigned to 3 groups that each received a 2‐step treatment course. In Step 1, the groups received treatments of: (i) survivin 2B peptide (SVN‐2B) plus interferon‐β (IFNβ); (ii) SVN‐2B only; or (iii) placebo until the patients show progression. In Step 2, all patients who consented to participate received 4 treatments with SVN‐2B plus IFNβ. The primary endpoint was progression‐free survival (PFS) after initiation of Step 1 treatment. Secondary endpoints included immunological effects assessed by analysis of PBMCs after Step 1. Eighty‐three patients were randomly assigned to receive SVN‐2B plus IFNβ (n = 30), SVN‐2B (n = 34), or placebo (n = 19). No significant improvement in PFS was observed. Survivin 2B‐specific CTLs were found to be increased in the SVN‐2B plus IFNβ group by tetramer assay. Among patients who participated in Step 2, those who had received SVN‐2B plus IFNβ in Step 1 showed better overall survival compared with those who had received placebo in Step 1. Patients vaccinated with SVN‐2B plus IFNβ did not have improved PFS, but showed significant immunological reaction after vaccination. Subgroup analysis suggested that a longer SVN‐2B plus IFNβ vaccination protocol might confer survival benefit. (Clinical trial registration number: UMIN 000012146).     

Self-ligating brackets exhibit accumulation of high levels of periodontopathogens in gingival crevicular fluid

Odontology - Different types of brackets seem to influence the disruption of the oral microbial environment. Therefore, the aim of this study was to evaluate the influence of self-ligating brackets...     

Effects of rice fermented extracts, “Sake Lees”, on the functional activity of odontoblast-like cells (KN-3 cells)

Odontology - This study was designed to investigate the effects of Sake Lees extracts (SLE, Sake Kasu) on the functional activity of odontoblastic cells and tooth pulp of the rats. For in vitro...     

The clinical significance of perioperative inflammatory index as a prognostic factor for patients with retroperitoneal soft tissue sarcoma

International Journal of Clinical Oncology - The prognostic factors of retroperitoneal soft tissue sarcoma (STS) have been explored but not yet certain. This study evaluated the prognostic impact...