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  1. Article ; Online: Intraductal Papillary Mucinous Neoplasm of the Pancreas

    Charikleia Triantopoulou / Sofia Gourtsoyianni / Dimitriοs Karakaxas / Spiros Delis

    Diagnostics, Vol 13, Iss 2015, p

    A Challenging Diagnosis

    2023  Volume 2015

    Abstract: Intraductal papillary mucinous neoplasm of the pancreas (IPMN) was classified as a distinct entity from mucinous cystic neoplasm by the WHO in 1995. It represents a mucin-producing tumor that originates from the ductal epithelium and can evolve from ... ...

    Abstract Intraductal papillary mucinous neoplasm of the pancreas (IPMN) was classified as a distinct entity from mucinous cystic neoplasm by the WHO in 1995. It represents a mucin-producing tumor that originates from the ductal epithelium and can evolve from slight dysplasia to invasive carcinoma. In addition, different aspects of tumor progression may be seen in the same lesion. Three types are recognized, the branch duct variant, the main duct variant, which shows a much higher prevalence for malignancy, and the mixed-type variant, which combines branch and main duct characteristics. Advances in cross-sectional imaging have led to an increased rate of IPMN detection. The main imaging characteristic of IPMN is the dilatation of the pancreatic duct without the presence of an obstructing lesion. The diagnosis of a branch duct IPMN is based on the proof of its communication with the main pancreatic duct on MRI-MRCP examination. Early identification by imaging of the so-called worrisome features or predictors for malignancy is an important and challenging task. In this review, we will present recent imaging advances in the diagnosis and characterization of different types of IPMNs, as well as imaging tools available for early recognition of worrisome features for malignancy. A critical appraisal of current IPMN management guidelines from both a radiologist’s and surgeon’s perspective will be made. Special mention is made of complications that might arise during the course of IPMNs as well as concomitant pancreatic neoplasms including pancreatic adenocarcinoma and pancreatic endocrine neoplasms. Finally, recent research on prognostic and predictive biomarkers including radiomics will be discussed.
    Keywords intraductal papillary mucinous tumor ; pancreas ; CT ; MRI ; PETA ; EUS ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2023-06-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Duplicated gallbladder

    Ludmila Baltaga / Dimosthenis Chrysikos / Spiros Delis / Charina Triantopoulou / Dimitrios Filippou / Vasileios Protogerou / Theodore Troupis

    Folia Medica, Vol 65, Iss 5, Pp 834-

    an incidental anatomical variation in a patient with symptomatic cholelithiasis

    2023  Volume 838

    Abstract: Congenital malformations of the biliary tract represent a relatively rare entity with which surgeons, radiologists and clinicians are not adequately familiarized. We present a rare case of gallbladder duplication in a 40-year-old female, with the ... ...

    Abstract Congenital malformations of the biliary tract represent a relatively rare entity with which surgeons, radiologists and clinicians are not adequately familiarized. We present a rare case of gallbladder duplication in a 40-year-old female, with the accessory cystic duct entering the left hepatic duct, which depicts the fifth reported case in the international bibliography. Our case illustrates the importance of detailed knowledge of anatomical malformations of the biliary tree, serving the purpose of a preoperative diagnosis of symptomatic cholelithiasis. It is also of paramount importance to take under consideration biliary tract malformations to avoid inadvertent complications such as biliary duct injuries in case of laparoscopic cholecystectomy.
    Keywords Medicine ; R
    Language English
    Publishing date 2023-10-01T00:00:00Z
    Publisher Pensoft Publishers
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Rare cystic liver lesions

    Christos Dervenis / Charina Triantopoulou / Spiros Delis / Andreas Bakoyiannis

    World Journal of Gastroenterology, Vol 19, Iss 43, Pp 7603-

    A diagnostic and managing challenge

    2013  Volume 7619

    Abstract: Cystic formations within the liver are a frequent finding among populations. Besides the common cystic lesions, like simple liver cysts, rare cystic liver lesions like cystadenocarcinoma should also be considered in the differential diagnosis. Thorough ... ...

    Abstract Cystic formations within the liver are a frequent finding among populations. Besides the common cystic lesions, like simple liver cysts, rare cystic liver lesions like cystadenocarcinoma should also be considered in the differential diagnosis. Thorough knowledge of each entity’s nature and course are key elements to successful treatment. Detailed search in PubMed, Cochrane Database, and international published literature regarding rare cystic liver lesions was carried out. In our research are included not only primary rare lesions like cystadenoma, hydatid cyst, and polycystic liver disease, but also secondary ones like metastasis from gastrointestinal stromal tumors lesions. Up-to date knowledge regarding diagnosis and management of rare cystic liver lesions is provided. A diagnostic and therapeutic algorithm is also proposed. The need for a multidisciplinary approach by a team including radiologists and surgeons familiar with liver cystic entities, diagnostic tools, and treatment modalities is stressed. Patients with cystic liver lesions must be carefully evaluated by a multidisciplinary team, in order to receive the most appropriate treatment, since many cystic liver lesions have a malignant potential and evolution.
    Keywords Liver cyst ; Cystic tumor ; Hepatic lesion ; Gastrointestinal stromal tumors ; Metastases ; Cystadenoma ; Cystadenocarcinoma ; Hydatid cyst ; Polycystic liver disease ; Caroli ; Echinococcus ; Diseases of the digestive system. Gastroenterology ; RC799-869 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Gastroenterology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Subject code 610
    Language English
    Publishing date 2013-01-01T00:00:00Z
    Publisher Baishideng Publishing Group Co., Limited
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Asymptomatic Calcitonin-Secreting Tumor of the Pancreas. A Case Report

    Spiros Delis / Andreas Bakoyiannis / Costas Avgerinos / Christos Dervenis / Niki Giannakou / Alexia Tsigka

    JOP Journal of the Pancreas, Vol 7, Iss 1, Pp 70-

    2006  Volume 73

    Abstract: Context :Pancreatic endocrine tumors are unusual tumors arising from cells belonging generically to the amine precursor uptake and decarboxylation system. Case report :We present a case of a calcitonin-secreting pancreatic endocrine tumor in a 59-year- ... ...

    Abstract Context :Pancreatic endocrine tumors are unusual tumors arising from cells belonging generically to the amine precursor uptake and decarboxylation system. Case report :We present a case of a calcitonin-secreting pancreatic endocrine tumor in a 59-year-old male who presented at our Center with elevated calcitonin values. The patient was asymptomatic. Further investigation revealed a tumor, 80 mm in diameter, in the pancreatic body and tail along with three metastatic lesions in segments III, V, and VIII of the liver. Following a distal pancreatectomy, splenectomy and wedge resection of segments III and V along with radiofrequency ablation of the segment VIII lesion, his serum calcitonin reached normal values. Conclusions :Calcitonin-secreting pancreatic endocrine tumors are often malignant and have a poor prognosis. We believe that an aggressive surgical approach may improve survival
    Keywords Calcitonin ; Endocrine Gland Neoplasms ; Pancreatic Neoplasms ; Medicine ; R ; Internal medicine ; RC31-1245 ; Specialties of internal medicine ; RC581-951 ; Diseases of the digestive system. Gastroenterology ; RC799-869
    Subject code 610
    Publishing date 2006-01-01T00:00:00Z
    Publisher E S Burioni Ricerche Bibliografiche
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Vascular complications of pancreas transplantation.

    Delis, Spiros / Spiros, Delis / Dervenis, Christos / Christos, Dervenis / Bramis, John / John, Bramis / Burke, George W / Miller, Joshua / Ciancio, Gaetano

    Pancreas

    2004  Volume 28, Issue 4, Page(s) 413–420

    Abstract: Objective: The purpose of our study was to focus on the early diagnosis and treatment of vascular complications after simultaneous pancreas-kidney (SPK) transplantation. Description of the technique for salvage of the graft after venous thrombosis (VT) ... ...

    Abstract Objective: The purpose of our study was to focus on the early diagnosis and treatment of vascular complications after simultaneous pancreas-kidney (SPK) transplantation. Description of the technique for salvage of the graft after venous thrombosis (VT) is also provided.
    Methods: From July 1994 to December 2002, 14 patients of 206 SPK transplant recipients had partial VT. Partial splenic VT (PSVT) was documented in 10 patients (4.8%), two had complete thrombosis of the splenic vein, one partial superior mesenteric thrombosis, and one developed partial thrombosis of the splenic and superior mesenteric vein. Four patients developed complete VT of the pancreas allograft and one superior mesenteric artery thrombosis. Our experience with four arteriovenous fistulae is also reported. The immunosuppression included tacrolimus, steroids, and monoclonal antibody to the IL-2 receptor. Thymoglobulin was introduced in June 2000 in our protocol combined with rapamycin or mycophenolate mofetil. These cases were identified following the intravenous (iv) use of tacrolimus with or without anti-IL-2R therapy. One case of complete VT is also reported one month following transplantation in a recipient with high rapamycin levels. Diagnosis was established during routine color Doppler ultrasonography.
    Results: Partial VT was effectively treated with anticoagulation. Complete VT required surgical thrombectomy. In our series, the pancreas was salvaged successfully in all patients with the technique described here.
    Conclusion: Early diagnosis of vascular complications after pancreas transplantation is of paramount importance for the appropriate treatment with organ salvage. Based on our experience, we suggest that VT can be effectively treated with anticoagulation. Aspirin is sufficient for PSVT.
    MeSH term(s) Adult ; Humans ; Incidence ; Kidney Transplantation/methods ; Middle Aged ; Pancreas Transplantation/adverse effects ; Pancreas Transplantation/methods ; Pancreas Transplantation/pathology ; Retrospective Studies ; Ultrasonography ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/etiology ; Venous Thrombosis/therapy
    Language English
    Publishing date 2004-04-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632831-3
    ISSN 1536-4828 ; 0885-3177
    ISSN (online) 1536-4828
    ISSN 0885-3177
    DOI 10.1097/00006676-200405000-00010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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