169 results on '"Luis Sabater"'
Search Results
102. Artery first approach in pancreatic surgery
- Author
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E. Muñoz Forner, M.C. Fernández Moreno, J. J. Ortega, Dimitri Dorcaratto, Á. García-Granero, Luis Sabater, and M. Garcés Albir
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medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,General surgery ,Gastroenterology ,medicine ,business ,Surgery ,Artery ,Pancreatic surgery - Published
- 2017
103. Recomendaciones para el diagnóstico, la estadificación y el tratamiento de las lesiones premalignas y el adenocarcinoma de páncreas
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Joan Fabregat, Eva C. Vaquero, Gloria Fernández-Esparrach, Luis Sabater, Juan Ramón Ayuso, Xavier Molero, Angels Ginès, Marta Martin-Richard, Ramiro Méndez, Miriam Cuatrecasas, Joan Maurel, and Antonio Ferrández
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03 medical and health sciences ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,Medicine ,030211 gastroenterology & hepatology ,General Medicine ,business ,Humanities - Abstract
Resumen Antecedentes y objetivo El tratamiento del adenocarcinoma de pancreas es complejo y requiere un enfoque multidisciplinar, al igual que sucede con las lesiones premalignas, cuyo diagnostico es cada vez mas frecuente. Este documento constituye una puesta al dia sobre el diagnostico y el tratamiento de las lesiones premalignas y del adenocarcinoma de pancreas. Pacientes y metodo Para ello, el Grupo Espanol Multidisciplinar en Cancer Digestivo organizo una conferencia en Barcelona durante la cual un panel formado por expertos en esta enfermedad, procedentes de diversas especialidades (Gastroenterologia, Cirugia, Radiologia, Anatomia Patologica, Oncologia Medica y Oncologia Radioterapica), establecio las bases para la revision y la elaboracion del manuscrito. Resultados Se ha revisado la literatura, discutido y, finalmente, deliberado sobre las evidencias. Conclusiones Con todo ello, se han establecido unas recomendaciones.
- Published
- 2016
104. Disfunción temprana del metabolismo hidrocarbonado en la pancreatitis crónica. Relación con la función exocrina pancreática
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Juan Sastre Belloch, José Manuel Rodrigo Gómez, Bruno Camps Vilata, Daniel Bautista Rentero, Julio Calvete Chornet, Luis Aparisi Quereda, and Luis Sabater Ortí
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,General Medicine ,business - Abstract
Fundamento La relacion entre la funcion endocrina y exocrina en la pancreatitis cronica es controvertida. El objetivo de este trabajo fue evaluar el estado funcional del pancreas endocrino en relacion con el grado de insuficiencia exocrina, comparar el valor de la prueba de sobrecarga oral a la glucosa (SOG) frente a la glucemia basal y estudiar los diferentes grados de alteracion funcional exocrina y endocrina en funcion del tiempo de evolucion. Pacientes y Metodo Se ha estudiado a 73 pacientes con pancreatitis cronica. Las funciones exocrina y endocrina se han investigado mediante la prueba de secretina-CCK (PSC), grasas en heces y SOG. Resultados De los 8 pacientes con PSC normal, la mitad presentaba alteraciones del metabolismo hidrocarbonado y 2 eran diabeticos. De los 50 con insuficiencia exocrina moderada, la excrecion de grasas en heces fue patologica en el 20%, mientras que un 54% presentaba alteraciones endocrinas, con diabetes en el 40%. Todos los pacientes con insuficiencia exocrina grave eran diabeticos. La SOG demostro alteraciones en un 42% de los pacientes con glucemia basal normal. La mediana de evolucion de la pancreatitis cronica en los pacientes con alteraciones del metabolismo hidrocarbonado fue menor que en los pacientes con esteatorrea Conclusiones Segun el grado de reserva funcional exocrina, en la pancreatitis cronica hay una mayor proporcion de pacientes con alteraciones del metabolismo hidrocarbonado que de esteatorrea. La SOG detecta alteraciones en un alto porcentaje de pacientes con glucemia basal normal. La disfuncion del metabolismo de los hidratos de carbono aparece mas tempranamente que la excrecion patologica de grasas fecales.
- Published
- 2001
105. Bile duct injury during laparoscopic cholecystectomyrid
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Salvador Lledó, A. Gomez-Portilla, Bruno Camps, Luis Sabater, A. Verdú, Julio Calvete, J. Martín, M. A. Torrico, Norberto Cassinello, and B. Flor
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,education ,behavioral disciplines and activities ,mental disorders ,Humans ,Medicine ,Prospective Studies ,Intraoperative Complications ,Prospective cohort study ,Laparoscopy ,Aged ,medicine.diagnostic_test ,business.industry ,Bile duct ,Gallbladder ,General surgery ,Middle Aged ,humanities ,Surgery ,medicine.anatomical_structure ,Cholecystectomy, Laparoscopic ,Biliary tract ,Female ,Cholecystectomy ,Bile Ducts ,Clinical Competence ,business ,Complication ,Abdominal surgery - Abstract
Bile duct injury (BDI) is a severe complication of laparoscopic cholecystectomy (LC) that is probably related to the effects of the learning curve. The aim of this prospective, institutional, and longitudinal study is to compare the incidence of BDI during LC in relation to the progressive experience of surgeons.A total of 784 LC were examined during a 6-year period. They were divided into the following three consecutive groups: group A (1993-94), group B (1995-96), and group C (1997-98). Incidence and type of BDI, experience of the surgeon, intra- or postoperative diagnosis, treatment performed to repair the injury, and early and late morbidity and mortality were evaluated.The overall incidence of BDI was 1.4%. There were three cases of transection of the common bile duct, four partial lesions of the bile duct, and four cystic leakages. The number of BDI was maintained over the three different time periods; there were no statistical differences in the proportion of injuries among groups. Most BDI were incurred by experienced surgeons. In all, 36% of BDI were recognized intraoperatively. Hepaticojejunostomy, direct suture over a T-tube, and closure of the cystic stump were done to repair BDI. There was no additional morbidity or mortality in the patients with BDI.No relation was found between the experience of the surgeon and the number of BDI over the different periods of time. Therefore, BDI during LC cannot be attributed solely to the learning curve.
- Published
- 2000
106. Pseudoaneurysm of the superior mesenteric artery: A life-threatening complication after pancreatic surgery
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Juan-Pablo Ortega, J.M. Gamez del Castillo, Jorge Guijarro, Elena Muñoz, M. Garcés, J. Soria, Oscar Ferro, and Luis Sabater
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medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,medicine.disease ,Pancreatic surgery ,Surgery ,Pseudoaneurysm ,medicine.artery ,medicine ,Superior mesenteric artery ,Radiology ,Complication ,business - Published
- 2015
107. Outcome quality standards in pancreatic oncologic surgery
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Álvaro García-Granero, María del Carmen Gómez-Mateo, Luis Sabater, Javier Escrig-Sos, Joaquín Ortega, Antonio Ferrández, and Juan Sastre
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medicine.medical_specialty ,Quality Assurance, Health Care ,business.industry ,medicine.medical_treatment ,media_common.quotation_subject ,General surgery ,MEDLINE ,Outcome assessment ,Prognosis ,Outcome (game theory) ,Oncologic surgery ,Surgery ,Pancreatic Neoplasms ,Pancreatectomy ,Oncology ,Surgical oncology ,Outcome Assessment, Health Care ,medicine ,Humans ,Quality (business) ,business ,Quality assurance ,media_common - Abstract
To identify quality indicators and establish acceptable quality limits (AQLs) in pancreatic oncologic surgery using a formal statistical methodology.Indicators have been identified through systematic literature reviews and guidelines for pancreatic surgery. AQLs were determined for each indicator with confidence intervals of 99.8 and 95 % above and below the weighted average by sample size from the different series examined.Several indicators have been identified with the following results as AQLs: resectability rate59 %; morbidity, mortality, and pancreatic fistula rate in pancreaticoduodenectomy55,5, and16 %, respectively; morbidity, mortality, and fistula rate in distal pancreatectomy53,4, and31 %, respectively; number of lymph nodes retrieved15; R1 resection46 %; survival at 1, 3, and 5 years54,19, and8 %, respectively.A series of different indicators for quality surgical care outcome in pancreatic cancer, as well as their limits, have been determined according to a standard methodology.
- Published
- 2013
108. Recomendaciones del Club Español Pancreático para el diagnóstico y tratamiento de la pancreatitis crónica: parte 2 (tratamiento)
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Gonzalo de las Heras, Luisa Guarner, Óscar Moreno-Pérez, Katherine García-Malpartida, Salvador Navarro, Julio Iglesias-Garcia, Juan José Martínez, Félix Lluís, Luis Gómez, A Farré, Jaume Boadas, Laureano Fernández-Cruz, José Ramón Aparicio, Jose Lariño-Noia, Enrique de-Madaria, Yolanda Sastre, Evangelina Boix, Luis Sabater, Enrique Dominguez-Munoz, Ángel Luis Abad-González, Eva C. Vaquero, José María Palazón, Antonio López, Luis Aparisi, Miguel Pérez-Mateo, and Xavier Molero
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medicine.medical_specialty ,Hepatology ,business.industry ,General surgery ,Gastroenterology ,MEDLINE ,Evidence-based medicine ,Disease ,medicine.disease ,Asymptomatic ,Pancreatic fistula ,medicine ,Portal hypertension ,Pancreatitis ,medicine.symptom ,business ,Exocrine pancreatic insufficiency - Abstract
Chronic pancreatitis (CP) is a complex disease with a wide spectrum of clinical manifestations ranging from asymptomatic disease to disabling forms or serious complications. The management of CP frequently differs among geographical areas and even among centers. These differences are due to the scarcity of high-quality studies and clinical practice guidelines that focus on the diagnosis and treatment of this disease. The aim of the Spanish Pancreatic Club was to create evidence-based recommendations for the management of CP. Two coordinators chose a multidisciplinary panel of 24 experts in this disease. These experts were selected on the basis of their clinical and research experience in CP. A list of questions was drawn up and each question was then reviewed by two panelists. These questions were then used to produce a draft, which was discussed in a face-to-face meeting with all the participants. Levels of evidence were based on the classification of the Oxford Centre for Evidence-Based Medicine. In the second part of the consensus process, recommendations were established for the management of pain, pseudocysts, biliary and duodenal stenosis, pancreatic fistula and ascites, left portal hypertension, diabetes mellitus, exocrine pancreatic insufficiency, and nutritional support in CP.
- Published
- 2013
109. Recommendations of the Spanish pancreatic club on the diagnosis and treatment of chronic pancreatitis: part 1 (diagnosis)
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Juan, Martínez, Ángel, Abad-González, José Ramón, Aparicio, Luis, Aparisi, Jaume, Boadas, Evangelina, Boix, Gonzalo, de las Heras, Enrique, Domínguez-Muñoz, Antonio, Farré, Laureano, Fernández-Cruz, Luis, Gómez, Julio, Iglesias-García, Katherine, García-Malpartida, Luisa, Guarner, José, Lariño-Noia, Félix, Lluís, Antonio, López, Xavier, Molero, Óscar, Moreno-Pérez, Salvador, Navarro, José M, Palazón, Miguel, Pérez-Mateo, Luis, Sabater, Yolanda, Sastre, Eva C, Vaquero, and Enrique, De-Madaria
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Consensus ,Pancreatitis, Chronic ,Diagnosis ,Exocrine pancreatic insufficiency ,Humans ,Clinical practice guidelines ,Chronic pancreatitis - Abstract
Chronic pancreatitis (CP) is a relatively uncommon, complex and highly heterogeneous disease. There is no clear pattern applicable to the initial stages of CP, which hampers its early diagnosis. Some of the complications of CP, especially chronic pain, can be difficult to manage. There is wide variation in the diagnosis and treatment of CP and its complicatiOns among centers and health professionals. The Spanish Pancreatic Club has developed a consensus document on the management of CP. Two coordinators chose a multidisciplinary panel of 24 experts in this disease. A list of questions was drawn up. Each question was reviewed by two experts. These questions were then used to produce a draft, which was discussed in a face-to-face meeting with all the participants. The first part of the consensus document focusses on the diagnosis of CP and its complications. (C) 2012 Elsevier Espana, S.L. and AEEH y AEG. All rights reserved.
- Published
- 2013
110. Recommendations of the Spanish Pancreatic Club on the diagnosis and treatment of chronic pancreatitis: Part 2 (treatment)
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Enrique, de-Madaria, Ángel, Abad-González, José Ramón, Aparicio, Luis, Aparisi, Jaume, Boadas, Evangelina, Boix, Gonzalo, de Las Heras, Enrique, Domínguez-Muñoz, Antonio, Farré, Laureano, Fernández-Cruz, Luis, Gómez, Julio, Iglesias-García, Katherine, García-Malpartida, Luisa, Guarner, José, Lariño-Noia, Félix, Lluís, Antonio, López, Xavier, Molero, Óscar, Moreno-Pérez, Salvador, Navarro, José María, Palazón, Miguel, Pérez-Mateo, Luis, Sabater, Yolanda, Sastre, Eva C, Vaquero, and Juan, Martínez
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Treatment ,Consensus ,Nutritional Support ,Pancreatitis, Chronic ,Decision Trees ,Exocrine pancreatic insufficiency ,Humans ,Clinical practice guidelines ,Chronic pancreatitis - Abstract
Chronic pancreatitis (CP) is a complex disease with a wide spectrum of clinical manifestations ranging from asymptomatic disease to disabling forms or serious complications. The management of CP frequently differs among geographical areas and even among centers. These differences are due to the scarcity of high-quality studies and clinical practice guidelines that focus on the diagnosis and treatment of this disease. The aim of the Spanish Pancreatic Club was to create evidence-based recommendations for the management of CP. Two coordinators chose a multidisciplinary panel of 24 experts in this disease. These experts were selected on the basis of their clinical and research experience in CP. A list of questions was drawn up and each question was then reviewed by two panelists. These questions were then used to produce a draft, which was discussed in a face-to-face meeting with all the participants. Levels of evidence were based on the classification of the Oxford Centre for Evidence-Based Medicine. In the second part of the consensus process, recommendations were established for the management of pain, pseudocysts, biliary and duodenal stenosis, pancreatic fistula and ascites, left portal hypertension, diabetes mellitus, exocrine pancreatic insufficiency, and nutritional support in CP. (C) 2012 Elsevier Espana, S.L. and AEEH y AEG. All rights reserved.
- Published
- 2013
111. Recomendaciones del Club Español Pancreático para el diagnóstico y tratamiento de la pancreatitis crónica: parte 1 (diagnóstico)
- Author
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Juan Martínez, Ángel Abad-González, José Ramón Aparicio, Luis Aparisi, Jaume Boadas, Evangelina Boix, Gonzalo de las Heras, Enrique Domínguez-Muñoz, Antonio Farré, Laureano Fernández-Cruz, Luis Gómez, Julio Iglesias-García, Katherine García-Malpartida, Luisa Guarner, José Lariño-Noia, Félix Lluís, Antonio López, Xavier Molero, Óscar Moreno-Pérez, Salvador Navarro, José M. Palazón, Miguel Pérez-Mateo, Luis Sabater, Yolanda Sastre, Eva C. Vaquero, and Enrique De-Madaria
- Subjects
Hepatology ,Gastroenterology - Abstract
Chronic pancreatitis (CP) is a relatively uncommon, complex and highly heterogeneous disease. There is no clear pattern applicable to the initial stages of CP, which hampers its early diagnosis. Some of the complications of CP, especially chronic pain, can be difficult to manage. There is wide variation in the diagnosis and treatment of CP and its complications among centers and health professionals. The Spanish Pancreatic Club has developed a consensus document on the management of CP. Two coordinators chose a multidisciplinary panel of 24 experts in this disease. A list of questions was drawn up. Each question was reviewed by two experts. These questions were then used to produce a draft, which was discussed in a face-to-face meeting with all the participants. The first part of the consensus document focusses on the diagnosis of CP and its complications.
- Published
- 2013
112. Laparoscopic Unilateral and Bilateral Adrenalectomy for Cushing's Syndrome
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A. Saenz, Emiliano Astudillo, Luis Sabater, Laureano Fernández-Cruz, Pilar Taura, and Guerson Benarroch
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Adenoma ,Adult ,Male ,Laparoscopic surgery ,Mean arterial pressure ,medicine.medical_specialty ,Adolescent ,Partial Pressure ,medicine.medical_treatment ,Hemodynamics ,Cushing syndrome ,Pneumoperitoneum ,Adrenal Glands ,medicine ,Humans ,Obesity ,Cushing Syndrome ,Aged ,Hyperplasia ,business.industry ,Adrenalectomy ,Carbon Dioxide ,Middle Aged ,medicine.disease ,Surgery ,Female ,Laparoscopy ,business ,Pneumoperitoneum, Artificial ,Research Article ,Abdominal surgery - Abstract
OBJECTIVE: This prospective randomized study compares the safety and efficacy of transperitoneal laparoscopic adrenalectomy (TLPA) and retroperitoneal approach (RLPA) in obese patients with Cushing's syndrome. SUMMARY BACKGROUND DATA: Recently, a retroperitoneal laparoscopic approach has been described with benefits of avoiding the respiratory and hemodynamic effects of carbon dioxide (CO2) pneumoperitoneum and giving direct access without the need to mobilize abdominal organs. METHODS: Twenty-one adrenalectomies were performed in 9 patients (2 men, 7 women; mean age, 46.33 +/- 19.41 years old; range, 16 to 74 years old) with Cushing's adenoma and in 6 women (mean age, 41.83 +/- 9.97 years old; range, 34 to 62 years old) with Cushing's disease. Randomization gave 10 TLPA and 11 RLPA. Arterial blood gas samples, mean arterial pressure, heart rate, and clinical parameters were evaluated. RESULTS: The partial pressure of carbon dioxide (PaCO2) increased in both retroperitoneal and transperitoneal CO2 insufflation compared with basal values (p < 0.01), and the TLPA showed a greater rise in the PaCO2 level compared with the RLPA at 30 minutes (p < 0.05); simultaneously, a significant increase (p < 0.05) of mean arterial pressure was observed in the TLPA compared with RLPA. No significant changes in heart rate were observed in both groups. The operative time with the TLPA and RLPA in patients with adenoma was 88.75 versus 105 minutes, respectively (p = not significant [NS]), and in patients with bilateral hyperplasia was 271.66 versus 305 minutes, respectively (p = NS). No patients required blood transfusions. The number of doses of analgesic with TLPA and RLPA in patients with adenoma was 3.25 versus 3.5, respectively (p = NS), and in patients with bilateral hyperplasia was 7.66 versus 7.33, respectively (p = NS). The hospital stay with TLPA and RLPA in patients with adenoma was 3.0 versus 2.75 days, respectively (p = NS), and in patients with bilateral hyperplasia was 6.0 versus 6.66 days, respectively (p = NS). The days to return to normal activity with TLPA and RLPA in patients with adenoma were 12.5 versus 12.25, respectively (p = NS), and in patients with bilateral hyperplasia were 19.66 versus 19.33, respectively (p = NS). Two patients with bilateral hyperplasia and TLPA had urinary infection. CONCLUSIONS: Transperitoneal laparoscopic adrenalectomy and RLPA may become the techniques of choice for surgical removal of the adrenal lesions in Cushing's syndrome. The retroperitoneoscopic approach might be a better option in patients with previous abdominal surgery and in patients with pre-existing cardiorespiratory disease.
- Published
- 1996
113. [Multicentre study on hepatic adenomas]
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Cristina Dopazo, F. Pereira, José Luis Fernández Aguilar, Luis Díez Valladares, Carmen García Bernardo, Alberto José Gutiérrez Calvo, José María Jover, Andrés Valdivieso, A. Serrablo, Fernando Pardo, José Manuel Ramia, Joan Figueras, Luis Sabater, M. Teresa Albiol, and Karim Muffak
- Subjects
Adenoma ,Adult ,Male ,medicine.medical_specialty ,Abdominal pain ,Adolescent ,medicine.medical_treatment ,Liver transplantation ,Young Adult ,Medicine ,Hepatectomy ,Humans ,Laparoscopy ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Mortality rate ,Liver Neoplasms ,General Engineering ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Surgery ,Acute abdomen ,Female ,medicine.symptom ,business - Abstract
Introduction Hepatic adenomas (HA) are benign tumours which can present serious complications, and hence all were resected in the past. It has now been shown that those smaller than 3 cm not expressing β-catenin only result in complications in exceptional cases and therefore the therapeutic strategy has been changed. Materials and method Retrospective study in 14 HPB units. Inclusion criteria: patients with resected and histologically confirmed HA. Study period: 1995–2011. Results 81 patients underwent surgery. Age: 39.5 years (range: 14–75). Sex: female (75%). Consumption of oestrogen in women: 33%. Size: 8.8 cm (range, 1–20 cm). Only 6 HA (7.4%) were smaller than 3 cm. The HA median was 1 (range: 1–12). Nine patients had adenomatosis (>10 HA). A total of 51% of patients displayed symptoms, the most frequent (77%) being abdominal pain. Eight patients (10%) began with acute abdomen due to rupture and/or haemorrhage. A total of 67% of the preoperative diagnoses were correct. Surgery was scheduled for 90% of patients. The techniques employed were: major hepatectomy (22%), minor hepatectomy (77%), and one liver transplantation. A total of 20% were performed laparoscopically. The morbidity rate was 28%. There were no cases of mortality. Three patients had malignisation (3.7%). The follow-up period was 43 months (range 1–192). Two recurrences were detected and resected. Discussion Patients with resected HA are normally women with large lesions and oestrogen consumption was lower than expected. Its correct preoperative diagnosis is acceptable (70%). The major hepatectomy rate is 25% and the laparoscopy rate is 20%. There was a low morbidity rate and no mortality.
- Published
- 2012
114. DNA delivery to 'ex vivo' human liver segments
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Rafael Abargues, María José Herrero, A I Montilla, V Navarro, Luis Sabater, Salvador F. Aliño, G Guenechea, and Luis Sendra
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Genetic enhancement ,Green Fluorescent Proteins ,Gene Transfer Techniques ,Genetic Therapy ,Biology ,Gene delivery ,Hepatic Veins ,Molecular biology ,Green fluorescent protein ,Catheterization ,Liver ,In vivo ,Transcription (biology) ,Gene expression ,Injections, Intravenous ,Genetics ,Hydrodynamics ,Molecular Medicine ,Humans ,Molecular Biology ,Gene ,Ex vivo ,Plasmids - Abstract
Hydrodynamic injection is an efficient procedure for liver gene therapy in rodents but with limited efficacy in large animals, using an 'in vivo' adapted regional hydrodynamic gene delivery system. We study the ability of this procedure to mediate gene delivery in human liver segments obtained by surgical resection. Watertight liver segments were retrogradely injected from hepatic vein with a saline solution containing a plasmid bearing the enhanced green fluorescent protein (eGFP) gene, under different conditions of flow rate (1, 10 and 20 ml s(-1)) and final perfused volume. Samples were cultured for 1 to 2 days and used for microscopy and molecular analysis of gene expression. The fluorescent and immunohistochemistry studies indicated that in segments injected at =10 ml s(-1), good and wide gene expression was present in the liver sections and the molecular analysis reinforced the histological observation in a quantitative manner (index of apparent gene delivery: 10(2)-10(4) eGFP DNA copy per 100 pg of total DNA; transcription index: 10(5)-2 × 10(6) eGFP RNA copy per 100 ng of total RNA). In addition, injected gold nanoparticles (15 nm diameter) suggested that DNA delivery to hepatocytes must involve a facilitated permeation process without membrane disruption. In summary, we show that retrograde venous injection of watertight human liver segment is an anadromous procedure that results in wide liver gene delivery and good gene expression. However, additional studies will be necessary to clarify the influence of the prolonged ischemia injury to hepatocytes in our model.
- Published
- 2011
115. Foregut cystic malformations in the pancreas. Are definitions clearly established?
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María del Carmen, Gómez Mateo, Elena, Muñoz Forner, Luis, Sabater Ortí, and Antonio, Ferrández Izquierdo
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Adult ,Diagnosis, Differential ,Cholangitis ,Humans ,Female ,Pancreatic Cyst ,Pancreas - Abstract
Foregut cystic malformations are common lesions in the mediastinum but are rarely found in subdiaphragmatic locations. Only a few cases have been described within the pancreas where they can easily be misdiagnosed as cystic neoplasms.We herein present the case of a 37-year-old female with acute cholangitis in whom a diagnostic work-up revealed a 1 cm solid-cystic heterogeneous lesion located at the head of the pancreas. The patient underwent a pancreaticoduodenectomy. Pathological evaluation demonstrated a cystic cavity lined by pseudostratified tall columnar ciliated epithelium with goblet cells, but lacking cartilage or smooth muscle bundles. Thus, the final diagnosis of the lesion was a ciliated foregut cyst of the pancreas.A review of the cases published regarding these lesions shows great variability in the taxonomy and a lack of accuracy in the definitions of each different subtype. An easy to use algorithm for the diagnosis of foregut cystic malformations subtypes, based on epithelial lining and wall features, is presented.
- Published
- 2011
116. [Complications after pancreaticoduodenectomy]
- Author
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Laureano, Fernández-Cruz, Luis, Sabater, Joan, Fabregat, and Ugo, Boggi
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Pancreatic Fistula ,Postoperative Complications ,Time Factors ,Humans ,Postoperative Hemorrhage ,Gastrointestinal Motility ,Vascular Surgical Procedures ,Algorithms ,Pancreaticoduodenectomy - Abstract
The most frequent complications after pancreaticoduodenectomy are analysed in this review. These include, delayed gastric emptying, pancreatic fistula, post-operative bleeding, and the complications after vascular reconstruction in the cases of locally extended pancreatic cancer. For this, randomised prospective studies, systematic meta-analyses and clinical guidelines on the definition, clinical severity grade and treatment of these complications have been evaluated.
- Published
- 2011
117. Protein phosphatases and chromatin modifying complexes in the inflammatory cascade in acute pancreatitis
- Author
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Luis Sabater, Javier Pereda, Javier Escobar, Juan Sandoval, Gerardo López-Rodas, Juan Sastre, Luis Aparisi, and Alessandro Arduini
- Subjects
Histone deacetylase 5 ,biology ,Histone methyltransferase ,Histone H2A ,biology.protein ,Cancer research ,Histone acetyltransferase ,Histone deacetylase ,Topic Highlight ,SAP30 ,CREB ,Chromatin remodeling - Abstract
Acute pancreatitis is an inflammation of the pancreas that may lead to systemic inflammatory response syndrome and death due to multiple organ failure. Acinar cells, together with leukocytes, trigger the inflammatory cascade in response to local damage of the pancreas. Amplification of the inflammatory cascade requires up-regulation of pro-inflammatory cytokines and this process is mediated not only by nuclear factor κB but also by chromatin modifying complexes and chromatin remodeling. Among the different families of histone acetyltransferases, the p300/CBP family seems to be particularly associated with the inflammatory process. cAMP activates gene expression via the cAMP-responsive element (CRE) and the transcription factor CRE-binding protein (CREB). CREB can be phosphorylated and activated by different kinases, such as protein kinase A and MAPK, and then it recruits the histone acetyltransferase co-activator CREB-binding protein (CBP) and its homologue p300. The recruitment of CBP/p300 and changes in the level of histone acetylation are required for transcription activation. Transcriptional repression is also a dynamic and essential mechanism of down-regulation of genes for resolution of inflammation, which seems to be mediated mainly by protein phosphatases (PP1, PP2A and MKP1) and histone deacetylases (HDACs). Class II HDACs are key transcriptional regulators whose activities are controlled via phosphorylation-dependent nucleo/cytoplasmic shuttling. PP2A is responsible for dephosphorylation of class II HDACs, triggering nuclear localization and repression of target genes, whereas phosphorylation triggers cytoplasmic localization leading to activation of target genes. The potential benefit from treatment with phosphodiesterase inhibitors and histone deacetylase inhibitors is discussed.
- Published
- 2010
118. Naked DNA delivery to whole pig cardiac tissue by coronary sinus retrograde injection employing non-invasive catheterization
- Author
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Salvador F. Aliño, Salvador Lledó, Vicente Bodi, Francisco Dasí, María Jesús Bravo Sánchez, Inmaculada Noguera, María José Herrero, Luis Mainar, Luis Sabater, Ana Díaz, and Alejo Sempere
- Subjects
Pathology ,medicine.medical_specialty ,Catheters ,Genetic enhancement ,Green Fluorescent Proteins ,Sus scrofa ,Gene Expression ,Endogeny ,Biology ,Green fluorescent protein ,Catheterization ,Injections ,Drug Discovery ,Genetics ,medicine ,Animals ,Molecular Biology ,Gene ,Genetics (clinical) ,Coronary sinus ,Fluorescent Dyes ,Coronary Sinus ,Gene Transfer Techniques ,Heart ,Anatomy ,DNA ,Genetic Therapy ,Naked DNA ,Hydrodynamics ,Molecular Medicine ,Immunohistochemistry ,GAPDH Gene ,Female - Abstract
Background Hydrodynamic injection has demonstrated to be very efficient in the liver of small animals, although this procedure must be translated to the clinical practice in a milder but no less efficient way. The present study evaluates the capacity of non-invasive interventional catheterization as a procedure for naked DNA delivery to the heart in large animals. Methods Two catheters were placed in the coronary sinus: one of them to block blood circulation and the other to retrogradely inject 50 ml of a saline solution of DNA (20 µg/ml) containing the enhanced green fluorescent protein (EGFP) gene, at a flow rate of 5 ml/s. Results The results obtained show that EGFP protein, identified by immunohistochemistry, was present and widely distributed throughout the atrial and ventricular cardiac tissue. This observation agrees with the efficiency of EGFP gene delivery resulting in 1–200 EGFP gene copies per endogenous haploid genome. However, the transcription efficiency of the exogenous EGFP gene was at a ratio of 0.2–10 copies with respect to the endogenous GAPDH gene, suggesting that optimized gene constructs for expression in cardiac tissue could increase the final efficacy of gene transfer. Conclusions We conclude that the retrovenous injection of naked DNA in the coronary sinus employing the catheterization technique is an easy and probably safe method for whole cardiac gene transfer. Copyright © 2010 John Wiley & Sons, Ltd.
- Published
- 2010
119. [Recommendations for diagnosis, staging and treatment of pancreatic cancer (Part I). Grupo Español de Consenso en Cáncer de Páncreas]
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Salvador, Navarro, Eva, Vaquero, Joan, Maurel, Josep Antoni, Bombí, Carmen, De Juan, Jaime, Feliu, Laureano, Fernández Cruz, Angels, Ginés, Enrique, Girela, Ricardo, Rodríguez, Luis, Sabater, and Antonio, Zarco
- Subjects
Diagnostic Imaging ,Male ,Biopsy ,Incidence ,Adenocarcinoma ,Prognosis ,Neoplasm Proteins ,Pancreatic Neoplasms ,Genes, ras ,Pancreatectomy ,Risk Factors ,Biomarkers, Tumor ,Humans ,Keratins ,Mass Screening ,Female ,Neoplasm Staging - Published
- 2009
120. Cross-talk between oxidative stress and pro-inflammatory cytokines in acute pancreatitis: a key role for protein phosphatases
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Gerardo López-Rodas, Javier Escobar, Luis Aparisi, Luis Sabater, Juan Sandoval, Alessandro Arduini, Juan Sastre, and Javier Pereda
- Subjects
Inflammation ,medicine.disease_cause ,Proinflammatory cytokine ,Drug Discovery ,Phosphoprotein Phosphatases ,Medicine ,Animals ,Humans ,Pharmacology ,biology ,business.industry ,medicine.disease ,Systemic inflammatory response syndrome ,Oxidative Stress ,Pancreatitis ,Mitogen-activated protein kinase ,Immunology ,Acute Disease ,biology.protein ,Acute pancreatitis ,Cytokines ,Tumor necrosis factor alpha ,medicine.symptom ,Mitogen-Activated Protein Kinases ,business ,Oxidation-Reduction ,Oxidative stress ,Signal Transduction - Abstract
Acute pancreatitis is an acute inflammatory process localized in the pancreatic gland that frequently involves peripancreatic tissues. It is still under investigation why an episode of acute pancreatitis remains mild affecting only the pancreas or progresses to a severe form leading to multiple organ failure and death. Proinflammatory cytokines and oxidative stress play a pivotal role in the early pathophysiological events of the disease. Cytokines such as interleukin 1beta and tumor necrosis factor alpha initiate and propagate almost all consequences of the systemic inflammatory response syndrome. On the other hand, depletion of pancreatic glutathione is an early hallmark of acute pancreatitis and reactive oxygen species are also associated with the inflammatory process. Changes in thiol homestasis and redox signaling decisively contribute to amplification of the inflammatory cascade through mitogen activated protein kinase (MAP kinase) pathways. This review focuses on the relationship between oxidative stress, pro-inflammatory cytokines and MAP kinase/protein phosphatase pathways as major modulators of the inflammatory response in acute pancreatitis. Redox sensitive signal transduction mediated by inactivation of protein phosphatases, particularly protein tyrosin phosphatases, is highlighted.
- Published
- 2009
121. [Pancreatic and periampullary tumors: morbidity, mortality, functional results and long-term survival]
- Author
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Luis, Sabater, Julio, Calvete, Luis, Aparisi, Raul, Cánovas, Elena, Muñoz, Ramón, Añón, Susana, Roselló, Edith, Rodríguez, Bruno, Camps, Raquel, Alfonso, Carlos, Sala, Juan, Sastre, Andrés, Cervantes, and Salvador, Lledó
- Subjects
Adult ,Aged, 80 and over ,Male ,Pancreatic Neoplasms ,Survival Rate ,Ampulla of Vater ,Young Adult ,Adolescent ,Common Bile Duct Neoplasms ,Humans ,Female ,Middle Aged ,Aged - Abstract
To evaluate postoperative morbidity and mortality, pancreatic function and long-term survival in patients with surgically treated pancreatic or periampullar tumours.Cohort study including 160 patients consecutively operated on: 80 pancreaticoduodenectomies (PD), 30 distal pancreatectomies (DP), 7 total pancreatectomies, 4 central pancreatic resections and 3 ampullectomies. The tumour was not resected in 36 patients. Pancreatic function was evaluated by oral glucose tolerance test, faecal fat excretion and elastase.Resectability rate was 77.5%. In resected patients (n = 124), 38.7% had complications with a pancreatic fistula rate of 6.4% and a mortality rate of 4%. In PD, endocrine function worsened in 41% and 58.6% had steatorrhoea; these figures in DP were 53.6% and 21.7% respectively. In the 36 non-resected patients, postoperative morbidity was 27.7% and mortality 8.3%. Two and five-year survival rates in resected patients with pancreatic cancer were 42% and 9% respectively; in malignant ampulloma 71% and 53%; in mucinous adenocarcinomas 83% and 33%; in duodenal adenocarcinoma 100% and 75%; and in distal cholangiocarcinoma 50% and 50%.Morbidity associated with resective pancreatic surgery is still high, but perioperative mortality is low. Endocrine and exocrine disturbances are very common depending on the type of resection. Despite the associated morbidity and functional disorders, surgery provides long-term survival in selected cases.
- Published
- 2008
122. [Are the general and digestive surgery services prepared to offer a quality training according to the new teaching plans?]
- Author
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Eva M Montalvá, Orón, Luis Sabater, Ortí, Elena Muñoz, Forner, Ana M Sánchez, Romero, Antonio Vázquez, Tarragón, and Alberto López, Delgado
- Subjects
Education, Medical, Graduate ,General Surgery ,Surveys and Questionnaires ,Curriculum ,Digestive System Surgical Procedures - Abstract
In recent months we have witnessed an update of the residents training program and the regulation of important training aspects. Teaching units are an important aspect of the training process, which should be required to comply with the prerequisites adapted to changing times as a guarantee of quality.To identify areas for improvement in training, and the baseline resources of the units to deal with the implementation of the new training program.The study was carried out in all units with accredited educational programs in the Valencian Community with questionnaires answered by tutors and residents, and meetings held with them.The participation rate was high (100% of tutors and 92% of residents). Some deficiencies in the requirements of the surgical units and in the quality of the training felt by the residents are detected, mainly in the research and educational activity fields. Huge differences between hospitals are found.More attention must be paid to fulfilling all the requirements needed for the accreditation of the teaching units, with an emphasis on educational and research activities. The implementation of the new training program requires monitoring to minimise the differences found between the units.
- Published
- 2008
123. Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?
- Author
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Abdalla Wassel, Luis Sabater, Juan Del-Olmo, J M Rodrigo, Daniel Bautista, M A Serra, Ricardo Campello, Juan Sastre, and Luis Aparisi
- Subjects
Adult ,Indocyanine Green ,Male ,medicine.medical_specialty ,Pathology ,Cirrhosis ,Alcohol Drinking ,Pancreatitis, Alcoholic ,Encephalopathy ,Nutritional Status ,Asymptomatic ,Gastroenterology ,Severity of Illness Index ,Body Mass Index ,chemistry.chemical_compound ,Feces ,Liver Function Tests ,Clinical Research ,Liver Cirrhosis, Alcoholic ,Risk Factors ,Internal medicine ,Ascites ,medicine ,Humans ,Coloring Agents ,Aged ,medicine.diagnostic_test ,Pancreatic Elastase ,business.industry ,Smoking ,General Medicine ,Middle Aged ,medicine.disease ,Steatorrhea ,Alcoholism ,Pancreatic Function Tests ,chemistry ,Spain ,Case-Control Studies ,Pancreatitis ,Female ,medicine.symptom ,Liver function tests ,business ,Carrier Proteins ,Indocyanine green - Abstract
AIM: To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology, after excluding any other causes. METHODS: One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53), LC (n = 57), and asymptomatic alcoholic (n = 30). Clinical, biochemical and morphological characteristics, Child-Pugh index, indocyanine green test, and fecal pancreatic elastase-1 test were assessed. RESULTS: In patients with cirrhosis, major clinical manifestations of CP such as pancreatic pain and steatorrhea, as well as imaging alterations of CP such as calcifications, duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases, and elastase-1 test was altered in only 7%, and severely altered in none. In patients with CP, clinical characteristics of cirrhosis such as ascites, encephalopathy and gastrointestinal hemorrhage were present in one case, Child-Pugh grade > A in 5.7%, and altered indocyanine green test in 1.9% cases. In asymptomatic alcoholism, there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%, respectively, but other characteristics of cirrhosis or CP were absent. An inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic patients. CONCLUSION: There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology, but an inverse correlation between pancreatic and liver function tests. These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis.
- Published
- 2008
124. Pancreatitis autoinmune: pseudotumor inflamatorio, afectación multifocal, hipertensión portal y evolución a largo plazo
- Author
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J. Calvete, J. Sastre, Salvador Lledó, J. Tosca, Luis Aparisi, J. L. Beristain, Luis Sabater, M. Rausell, and A. Calatayud
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,Gastroenterology ,General Medicine ,Jaundice ,medicine.disease ,Retroperitoneal fibrosis ,medicine.anatomical_structure ,Esophageal varices ,medicine ,Portal hypertension ,Pancreatitis ,medicine.symptom ,Differential diagnosis ,Pancreas ,business ,Autoimmune pancreatitis - Abstract
Autoimmune pancreatitis is a recently characterized disease that still constitutes a diagnostic challenge, especially regarding differential diagnosis from neoplasia. Long-term outcome is poorly known. We herein report a case of a patient with autoimmune pancreatitis and 14 years of follow-up, and show its clinical, biochemical, and morphological characteristics. A 54-year-old female presented with obstructive jaundice and abdominal tenderness, as well as a mass at the pancreatic head on a CT scan, suggestive of pancreatic neoplasia. Surgery showed an increase of the whole pancreas, malignancy was intraoperatively ruled out, and a cholecystectomy and choledochoduodenostomy were carried out. The diagnosis was chronic pancreatitis. Over the following years different autoimmune complications developed, including asthma, salivary gland swelling, and sclerosing cholangitis, as well as recurrent episodes of jaundice, and exocrine and endocrine pancreatic failure. The development of these complications combined with the demonstration of high serum levels of IgG4 and carbonic anhydrase II led to a re-evaluation of the initial histology of the pancreas, leading to a final diagnosis of autoimmune pancreatitis: IgG4+ lymphoplasmacytic infiltrates, fibrosis, and obliterative phlebitis. New complications developed during the last few years: retroperitoneal fibrosis with portal hypertension, esophageal varices, and splenomegaly.
- Published
- 2008
125. Therapeutic Approach to Pancreatic Abscess
- Author
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Luis Sabater-Ortí, Julio Calvete-Chornet, and Salvador Lledó-Matoses
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medicine.medical_specialty ,Therapeutic approach ,business.industry ,medicine ,Radiology ,medicine.disease ,business ,Surgery ,Pancreatic abscess - Published
- 2007
126. [Effect of neoadjuvant chemotherapy on the results of resection of colorectal liver metastases]
- Author
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Purificación, Ivorra, Luis, Sabater, Julio, Calvete, Bruno, Camps, Andrés, Cervantes, Ana, Bosch, Cecilia, Plazzotta, Norberto, Cassinello, Patricia, Arlandis, and Salvador, Lledó
- Subjects
Adult ,Male ,Survival Rate ,Postoperative Complications ,Treatment Outcome ,Chemotherapy, Adjuvant ,Liver Neoplasms ,Humans ,Female ,Middle Aged ,Colorectal Neoplasms ,Combined Modality Therapy ,Aged - Abstract
Surgery is the treatment of choice in patients with colorectal liver metastases. However, only 10% to 20% of these cases are resectable. The use of neoadjuvant chemotherapy may allow surgery in patients with tumors initially considered unresectable. The aim of this study was to compare the results of liver resection due to colorectal liver metastases in patients with and without neoadjuvant chemotherapy.We studied 105 patients who underwent surgery for liver metastases from colorectal cancer. The patients were divided into two groups according to treatment: surgery in patients with initially resectable tumors (group 1) and neoadjuvant chemotherapy plus surgery (group 2) in patients with initially irresectable tumors, who were considered for surgery after response to chemotherapy. Age, sex, origin of primary tumor, time of presentation, number, maximum size and location of metastases, CEA, resection margin, postoperative morbidity and mortality, length of hospital stay, recurrence rate, survival and disease-free survival were compared between the 2 groups of patients.When group 1 was compared with group 2, statistically significant differences were observed in synchronicity (30.8% vs 77.4%), bilobarity (13.5% vs 58.5%), number and size of metastases (1 vs 3 nodules and 4 cm vs 2 cm), resectability rate (96.1% vs 81.1%), disease-free interval (25 vs 11 months) and long-term survival at 1, 3 and 5 years (93%, 67% and 36% vs 78%, 26% and 12%). However, no statistically significant differences were found in postoperative morbidity and mortality (28.8% and 0% in group 1 and 22.6% and 1.8% in group 2, respectively).Neoadjuvant chemotherapy was not associated with greater postoperative morbidity and mortality after resection of colorectal liver metastases, but long-term survival was lower in the group of patients receiving this treatment modality than in those with tumors initially considered resectable.
- Published
- 2007
127. Distal pancreatectomy with celiac axis resection for adenocarcinoma of the pancreatic body: The modified appleby procedure
- Author
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M. Fernández, Elena Muñoz, F. Morera, J.M. Gamez del Castillo, Oscar Ferro, Luis Sabater, Juan-Pablo Ortega, and M. Garcés
- Subjects
Pancreatic body ,medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,General surgery ,Gastroenterology ,Celiac axis ,medicine.disease ,Resection ,Medicine ,Adenocarcinoma ,Radiology ,business ,Distal pancreatectomy - Published
- 2015
128. Modified appleby procedure for resection of advanced pancreatic body-tail tumors with hepatic artery or celiac axis involvement
- Author
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Maria Carmen Fernandez, Francisco Morera, M. Garcés, Oscar Ferro, Jorge Guijarro, Luis Sabater, Joaquín Ortega, Juan Manuel Gámez del Castillo, Susana Roselló, and Elena Muñoz
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Pancreatic body ,medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,medicine ,Celiac axis ,Radiology ,business ,Resection ,Artery - Published
- 2015
129. Treatment of infected pancreatic necrosis: Outcome in a 9-year, single-center, consecutive series (2006-2014)
- Author
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Joan Tosca, Miguel Minguez, Paloma Lluch, Luis Sabater, Oswaldo Moreno, R Añón, Vicente Sanchiz, Isabel Pascual, N. Garcia, Francisco Mora, and A Peña
- Subjects
medicine.medical_specialty ,Series (stratigraphy) ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,Gastroenterology ,Medicine ,Infected pancreatic necrosis ,business ,Single Center - Published
- 2015
130. Complete pancreatic transection secondary to severe acute pancreatitis
- Author
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M. Garcés, M. Fernández, Oscar Ferro, Luis Sabater, J.M. Gamez del Castillo, F. Morera, R. Villagrasa, Juan-Pablo Ortega, and Vicente Sanchiz
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,Gastroenterology ,medicine ,Acute pancreatitis ,business ,medicine.disease - Published
- 2015
131. [Toward a new model of residency supervisor]
- Author
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Luis, Sabater Ortí
- Subjects
Education, Medical ,Spain ,Internship and Residency - Published
- 2006
132. [A single gallbladder calculus occupying the entire gallbladder]
- Author
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Stephanie, García-Botello, Julio, Calvete-Chornet, Luis, Sabater-Ortí, B, Flor-Lorente, Norberto, Cassinello-Fernández, José Antonio, March-Villalba, and Salvador, Lledó-Matoses
- Subjects
Humans ,Female ,Gallstones ,Aged - Published
- 2006
133. [Necrotizing soft tissue infection, with bacteria from the intestines in affected tissues]
- Author
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José Antonio, March-Villalba, Julio, Calvete-Chornet, Luis, Sabater-Ortí, David, Casado-Rodrigo, Bruno, Camps-Vilata, and Salvador, Lledó-Matoses
- Subjects
Intestines ,Necrosis ,Fatal Outcome ,Soft Tissue Infections ,Humans ,Female ,Aged - Published
- 2006
134. Antibodies to carbonic anhydrase and IgG4 levels in idiopathic chronic pancreatitis: relevance for diagnosis of autoimmune pancreatitis
- Author
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G. de las Heras, Luis Sabater, Marcos López-Hoyos, D Bautista, Juan Sastre, Salvador Navarro, Josefina Mora, S Mery, Luis Aparisi, Miguel Pérez-Mateo, A Farré, Juan José Martínez, A. Ferrández, L Gómez-Cambronero, and J Corts
- Subjects
Adult ,Male ,Systemic disease ,medicine.medical_specialty ,Pathology ,Pancreatic disease ,Adolescent ,Pancreatitis, Alcoholic ,Plasma Cells ,Enzyme-Linked Immunosorbent Assay ,Gastroenterology ,Carbonic Anhydrase II ,Autoimmune Diseases ,Diagnosis, Differential ,Internal medicine ,parasitic diseases ,Blood plasma ,medicine ,Humans ,Pancreas ,Autoimmune pancreatitis ,Aged ,Autoantibodies ,Autoimmune disease ,Aged, 80 and over ,integumentary system ,biology ,business.industry ,Autoantibody ,Middle Aged ,medicine.disease ,humanities ,Pancreatic Neoplasms ,Sjogren's Syndrome ,Pancreatitis ,Immunoglobulin G ,Acute Disease ,Chronic Disease ,biology.protein ,Commentary ,Female ,Antibody ,business ,Biomarkers - Abstract
Background: Increased serum antibodies against carbonic anhydrase II (CA-II Ab) or IgG4 levels have been reported in cases of autoimmune chronic pancreatitis (ACP). Aim: To assess the relevance of serum CA-II Ab and IgG4 levels for the diagnosis of ACP in idiopathic CP (ICP) versus alcoholic CP and Sjogren’s syndrome (SS). Subjects: This was a multicentre study involving 227 subjects divided into four groups: ICP (n = 54), normal controls (n = 54, paired by age and sex with ICP patients), alcoholic CP (n = 86), and SS (n = 33). Methods: CA-II Ab was measured by ELISA and confirmed by western blotting. A score of easy clinical use with major clinical, morphological, and biochemical parameters for the diagnosis of ACP was applied. Results: The percentage of patients with increased serum CA-II Ab was higher in the ICP group (28%) than in controls (1.9%) and in patients with alcoholic CP (10.5%), but lower than in patients with SS (64%). The proportion with elevated IgG4 levels was higher in the ICP group (15%) compared with controls (1.9%) and SS (0%) but not significantly different from alcoholic CP (8%). Most ICP patients (7/8) with high IgG4 levels exhibited increased CA-II Ab and a compatible ACP score. A definitive diagnosis of ACP by histological analysis was associated with other autoimmune disorders, an increase in both serum IgG4 and CA-II Ab levels, and IgG4 positive plasma cells. Conclusions: The increase in serum IgG4 levels was strongly associated with elevated CA-II Ab levels, manifestations compatible with ACP, and lymphoplasmacytic infiltration when surgical specimens were available.
- Published
- 2005
135. Inflammatory myofibroblastic tumor (inflammatory fibrosarcoma) of the pancreas: a case report
- Author
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Yuta, Nakamura, Kazuo, Inui, Junji, Yoshino, Takamasa, Tokoro, Luis, Sabater, Shin, Takeda, Katsuya, Yamashita, Osamu, Okochi, and Akimasa, Nakao
- Subjects
Adult ,Inflammation ,Radiography, Abdominal ,Fibrosarcoma ,Myocytes, Smooth Muscle ,Angiography ,Fibroblasts ,Immunohistochemistry ,Pancreatic Neoplasms ,Humans ,Vimentin ,Female ,Tomography, X-Ray Computed ,Ultrasonography - Abstract
Inflammatory myofibroblastic tumors (inflammatory fibrosarcomas) of the pancreas are extremely rare. We report a 29-year-old woman who underwent pancreatoduodenectomy for a 6-cm tumor of the pancreas head causing obstructive jaundice. Tumor involvement was local, without apparent metastasis. The tumor was composed of proliferating fibroblastic/or myofibroblast-like spindle cells and aggregates of chronic inflammatory cells in a fibromyxoid matrix. Immunohistochemical examination demonstrated reactivity only to vimentin. This tumor has often been found in the peritoneal cavity, the retroperitoneum, or the pelvic cavity, but only very rarely in the pancreas.
- Published
- 2005
136. Circulating TNF-alpha and its soluble receptors during experimental acute pancreatitis
- Author
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Norberto Cassinello, Susana Granell, Luis Sabater, Javier Pereda, L Gómez-Cambronero, Juan Sastre, and Daniel Closa
- Subjects
Male ,medicine.medical_specialty ,Immunology ,Inflammation ,Biochemistry ,DNA-binding protein ,Receptors, Tumor Necrosis Factor ,Pentoxifylline ,Internal medicine ,medicine ,SIRS ,Immunology and Allergy ,Animals ,Rats, Wistar ,Receptor ,Molecular Biology ,business.industry ,Tumor Necrosis Factor-alpha ,Hematology ,medicine.disease ,sTNF-αR ,Rats ,Disease Models, Animal ,Endocrinology ,Pancreatitis ,Solubility ,TNF-α ,Acute Disease ,Acute pancreatitis ,Tumor necrosis factor alpha ,medicine.symptom ,business ,medicine.drug - Abstract
Clinical and experimental studies have shown increased concentrations of TNF-α and its soluble receptors in serum of patients with acute pancreatitis. In this work, we have investigated the time-course of TNF-α and its soluble receptors during taurocholate-induced acute pancreatitis. In addition, since TNF-α itself could mediate the shedding of its receptors, we have assessed the effect of inhibiting TNF-α production on the release of soluble TNF-α receptors in experimental acute pancreatitis. Our results indicate that soluble receptors are released in the early stages of the disease and this increase is concomitant with the release of TNF-α, which is mainly bound to specific proteins. The increased concentrations of its receptors strongly suggest that they could be these binding proteins. Inhibition of TNF-α generation with pentoxifylline abrogated the shedding of sTNF-αR1, but had no effect on sTNF-αR2. This finding suggests that the shedding of sTNF-αR1 is induced by TNF-α itself, but in the case of sTNF-αR2, the shedding appears to be induced by another mechanism. © 2003 Elsevier Ltd. All rights reserved., This work was supported by grants GV01-137 from Generalitat Valenciana, 1FD1997-1616 from Ministerio de Ciencia y Tecnologı́a and 01/0949 FIS form Ministerio de Sanidad y Consumo; S. Granell was supported by a grant from IDIBAPS
- Published
- 2004
137. Mobilization of xanthine oxidase from the gastrointestinal tract in acute pancreatitis
- Author
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Luis Sabater, Oriol Bulbena, Susana Granell, Emilio Gelpí, Daniel Closa, Juan Sastre, and Meritxell Genescà
- Subjects
Male ,Taurocholic Acid ,Xanthine Oxidase ,Xanthine Dehydrogenase ,Pharmacology ,Binding, Competitive ,Intestinal absorption ,chemistry.chemical_compound ,medicine ,Animals ,Ascitic Fluid ,Endothelium ,lcsh:RC799-869 ,Rats, Wistar ,Xanthine oxidase ,Lung ,Peroxidase ,Gastrointestinal tract ,biology ,business.industry ,lung inflammation ,Gastroenterology ,Proteolytic enzymes ,General Medicine ,medicine.disease ,Rats ,α-amylase ,Xanthine dehydrogenase ,chemistry ,Pancreatitis ,Intestinal Absorption ,Myeloperoxidase ,Immunology ,Acute Disease ,Amylases ,biology.protein ,Acute pancreatitis ,lcsh:Diseases of the digestive system. Gastroenterology ,business ,Research Article - Abstract
This article is available from: http://www.biomedcentral.com/1471-230X/4/1, [Background] Xanthine oxidoreductase has been proposed to play a role in the development of local and systemic effects of acute pancreatitis. Under physiologic conditions, the enzyme exists mainly as xanthine dehydrogenase (XDH) but can be converted by proteolytic cleavage to its superoxide-generating form xanthine oxidase (XOD). In addition to its intracellular location XDH/XOD is also associated to the polysaccharide chains of proteoglycans on the external endothelial cell membrane. In the early stages of acute pancreatitis, this enzyme seems to be arising from its mobilization from the gastrointestinal endothelial cell surface. Taking into account the ability of α-amylase to hydrolyze the internal α-1,4 linkages of polysaccharides, we wanted to elucidate the involvement of α-amylase in XDH/XOD mobilization from the gastrointestinal endothelial cell surface and the relevance of the ascitic fluid (AF) as the source of α-amylase in experimental acute pancreatitis., [Methods] Acute pancreatitis was induced in male Wistar rats by intraductal administration of 5% sodium taurocholate. In another experimental group 3000 U/Kg α-amylase was i.v. administered. The concentrations of XDH, XOD and α- amylase in plasma and AF and myeloperoxidase (MPO) in lung have been evaluated. In additional experiments, the effect of peritoneal lavage and the absorption of α-amylase present in the AF by an isolated intestine have been determined., [Results] Similar increase in XDH+XOD activity in plasma was observed after induction of acute pancreatitis and after i.v. administration of α-amylase. Nevertheless, the conversion from XDH to XOD was only observed in the pancreatitis group. Lung inflammation measured as MPO activity was observed only in the pancreatitis group. In addition peritoneal lavage prevented the increase in α-amylase and XDH+XOD in plasma after induction of pancreatitis. Finally, it was observed that α-amylase is absorbed from the AF by the intestine., [Conclusions] During the early stages of acute pancreatitis, α-amylase absorbed from AF through the gastrointestinal tract could interfere with the binding of XDH/XOD attached to glycoproteins of the endothelial cells. Proteolytic enzymes convert XDH into its oxidase form promoting an increase in circulating XOD that has been reported to be one of the mechanisms involved in the triggering of the systemic inflammatory process., This work has been supported by FISss grants 01/0949 and PI020286; S.Granell and M.Genesca are recipients of IDIBAPS predoctoral grants.
- Published
- 2004
138. Pancreatic function after severe acute biliary pancreatitis: the role of necrosectomy
- Author
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J. Calvete, Pareja E, Luis Sabater, Sastre J, Oviedo M, Camps B, E. Artigues, Luis Aparisi, Trullenque R, and Lledó S
- Subjects
Blood Glucose ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Biliary Tract Diseases ,Gastroenterology ,Severity of Illness Index ,Excretion ,Cohort Studies ,Endocrinology ,Pancreatectomy ,Internal medicine ,Internal Medicine ,medicine ,Pancreatic function ,Endocrine system ,Humans ,Biliary pancreatitis ,Prospective Studies ,Prospective cohort study ,Pancreas ,Aged ,Hepatology ,business.industry ,Pancreatitis, Acute Necrotizing ,Insulin ,Glucose Tolerance Test ,Middle Aged ,medicine.disease ,Steatorrhea ,Pancreatic Function Tests ,Pancreatitis ,Female ,medicine.symptom ,business - Abstract
OBJECTIVES To investigate the recovery of pancreatic function after severe acute biliary pancreatitis (ABP), especially the influence of necrosectomy on endocrine and exocrine functions. METHODS Prospective cohort study including 39 patients with severe ABP. According to need or no need for surgical necrosectomy, patients were further subdivided into 2 groups. Functional pancreatic evaluation was carried out 12 months after the ABP episode. Endocrine function was evaluated by an oral glucose tolerance test and exocrine function by fecal fat excretion, fecal chymotrypsin (FQ), and secretin-cerulein tests (SCT). RESULTS Most of the patients with necrosectomy had an abnormal exocrine pancreatic function, with steatorrhea in 25%. In the group without surgery, exocrine function was pathologic in only 13.3% and there were no cases of steatorrhea. Endocrine function was pathologic in 75% of patients undergoing necrosectomy versus 26.7% in the nonoperated group. In this latter group, the patients with abnormal endocrine function did not require insulin therapy, while in 33.3% of patient in the necrosectomy group insulin was necessary. CONCLUSIONS In our homogeneous series of severe ABP, necrosectomy impaired significantly pancreatic endocrine and exocrine function. On the other hand, most patients with the same origin and severity index, but without surgical debridement, maintained normal pancreatic function.
- Published
- 2004
139. Effect of simultaneous inhibition of TNF-α production and xanthine oxidase in experimental acute pancreatitis: The role of mitogen activated protein kinases
- Author
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Norberto Cassinello, Emma Folch-Puy, Luis Aparisi, Miguel Cerdá, Julio Calvete, Javier Pereda, Salvador Lledó, L Gómez-Cambronero, Daniel Closa, Luis Sabater, Jose Viña, and Juan Sastre
- Subjects
MAPK/ERK pathway ,Male ,medicine.medical_specialty ,Xanthine Oxidase ,Oxypurinol ,Pharmacology ,chemistry.chemical_compound ,Internal medicine ,Medicine ,Animals ,Enzyme Inhibitors ,Pentoxifylline ,Phosphorylation ,Rats, Wistar ,Xanthine oxidase ,Protein kinase A ,Lung ,Pancreas ,Peroxidase ,biology ,business.industry ,Kinase ,Pancreatitis, Acute Necrotizing ,Tumor Necrosis Factor-alpha ,Ascites ,Original Articles ,medicine.disease ,Rats ,Enzyme Activation ,Oxidative Stress ,Endocrinology ,chemistry ,Mitogen-activated protein kinase ,biology.protein ,Acute pancreatitis ,Pancreatitis ,Surgery ,Tumor necrosis factor alpha ,Inflammation Mediators ,Mitogen-Activated Protein Kinases ,business - Abstract
Javier Pereda et al., Objective: To assess the effects of inhibiting both tumor necrosis factor (TNF)-α production and xanthine oxidase activity on the inflammatory response, mitogen-activated protein kinase (MAPK) activation and mortality in necrotizing acute pancreatitis in rats. Summary Background Data: Pancreatic injury triggers 2 major pathways involved in the systemic effects of severe acute pancreatitis: pro-inflammatory cytokines and oxidative stress. Methods: Pancreatitis was induced by intraductal infusion of 3.5% sodium taurocholate. We examined whether treatment with oxypurinol, a specific inhibitor of xanthine oxidase, and/or pentoxifylline, an inhibitor of TNF-α production, affects pancreatic damage, ascites, lung inflammation, and MAPK phosphorylation. Results: Oxypurinol prevented p38 phosphorylation in the pancreas and partially avoided the rise in lung myeloperoxidase activity. Pentoxifylline prevented erk 1/2 and JNK phosphorylation in the pancreas, and it partially reduced ascites and the rise in lung myeloperoxidase activity. Combined treatment with oxypurinol and pentoxifylline almost completely abolished ascites, MAPK phosphorylation in the pancreas, and the increase in lung myeloperoxidase activity. Histology revealed a reduction in pancreatic and lung damage. These changes were associated with a significant improvement of survival. Conclusions: Simultaneous inhibition of TNF-α production and xanthine oxidase activity greatly reduced local and systemic inflammatory response in acute pancreatitis and decreased mortality rate. These effects were associated with blockade of the 3 major MAPKs., This work was supported by the following Grants: Grant GV01-137 from Generalitat Valenciana, 1FD1997-1616 from Ministerio de Ciencia y Tecnología, and the 1rst Grant for research on exocrine pancreas from Solvay Pharma-Spain funded by Solvay Pharma and sponsored by ANEP to J. S.; and Grant BFI 2001-2849 from CICYT to J.V.
- Published
- 2004
140. Heparin mobilizes xanthine oxidase and induces lung inflammation in acute pancreatitis
- Author
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Susana Granell, Luis Aparisi, Julián Panés, Emili Gelpí, Oriol Bulbena, Meritxell Gironella, Luis Sabater, Daniel Closa, and Marcelo Mauri
- Subjects
Male ,medicine.medical_specialty ,Pancreatic disease ,P-selectin ,medicine.drug_class ,Low molecular weight heparin ,Inflammation ,Critical Care and Intensive Care Medicine ,Random Allocation ,chemistry.chemical_compound ,Free radical ,Internal medicine ,medicine ,Animals ,Xanthine oxidase ,Rats, Wistar ,business.industry ,Heparin ,Pneumonia ,Heparin, Low-Molecular-Weight ,medicine.disease ,Rats ,Systemic inflammatory response syndrome ,Endocrinology ,chemistry ,Pancreatitis ,Acute Disease ,Acute pancreatitis ,medicine.symptom ,business ,medicine.drug - Abstract
Objective: To evaluate the effect of low molecular weight heparin on plasma xanthine oxidase concentrations and lung inflammatory response during acute pancreatitis. Design: Randomized, controlled trial. Setting: Experimental laboratory. Subjects: Male Wistar rats. Interventions: Acute pancreatitis was induced by intraductal administration of 5% sodium taurocholate. Low molecular weight heparin (0, 30, 90, or 300 units/kg) was administered immediately after induction of pancreatitis. Measurements and Main Results: Lipase and xanthine oxidase plasma concentrations were measured 3 hrs after pancreatitis induction. Expression of P-selectin messenger RNA and myeloperoxidase activity as a marker of neutrophil infiltration were determined in the lung. An increase in xanthine oxidase plasma concentrations was observed during pancreatitis. Administration of heparin also increased plasma xanthine oxidase activity in both control and pancreatitis animals. Measures of xanthine oxidase present in the endothelial surface indicate that during pancreatitis, the enzyme is released from the gastrointestinal endothelium. By contrast, heparin mobilizes xanthine oxidase from almost all organs evaluated. Neutrophil infiltration was increased in the lung during pancreatitis. Heparin administration further increased, in a dose-dependent manner, myeloperoxidase activity and P-selectin expression in the lung in animals with pancreatitis. By contrast, in control animals, heparin had no effect on myeloperoxidase activity and did not induce P-selectin up-regulation. Conclusion: During acute pancreatitis, heparin administration might mobilize xanthine oxidase attached to endothelial cells, originating a free radical-generating system in the circulation that would trigger an inflammatory response in the lung.
- Published
- 2003
141. Haemoglobin in ascitic fluid increases lipid peroxidation in acute pancreatitis
- Author
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Javier Escobar, Javier Pereda, Luis Sabater, Salvador Pérez-Garrido, Juan Sastre, and D. Royo
- Subjects
Ascitic fluid ,medicine.medical_specialty ,business.industry ,medicine.disease ,Biochemistry ,Gastroenterology ,Lipid peroxidation ,chemistry.chemical_compound ,chemistry ,Physiology (medical) ,Internal medicine ,medicine ,Acute pancreatitis ,business - Published
- 2012
142. Arterial hypertension due to primary adrenal hydatid cyst
- Author
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Maria Dolores Escudero, Manuel Labiós, Julio Calvete, Luis Sabater, Salvador Lledó, and Bruno Camps
- Subjects
Adult ,medicine.medical_specialty ,business.industry ,Helminthiasis ,Adrenal Gland Diseases ,Anticestodal Agents ,Hydatid cyst ,Adrenalectomy ,medicine.disease ,Albendazole ,Surgery ,Echinococcosis ,Hypertension ,medicine ,Humans ,Female ,Complication ,business ,Tomography, X-Ray Computed - Published
- 2002
143. Pancreatic oncological surgery. Are the levels of excellence achievable?
- Author
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Luis Sabater Ortí
- Subjects
medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,General surgery ,General Engineering ,Oncological surgery ,Surgery ,Pancreatic Neoplasms ,Pancreatectomy ,Excellence ,medicine ,Humans ,business ,media_common - Published
- 2011
144. Pancreatic ascites haemoglobin up-regulates the HIF/VEGF pathway in the lung in severe acute pancreatitis
- Author
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Juan Sastre, Javier Pereda, Luis Sabater, and Salvador Pérez
- Subjects
medicine.medical_specialty ,Pathology ,Necrosis ,biology ,business.industry ,Interleukin ,Vascular permeability ,Inflammation ,medicine.disease ,Biochemistry ,Vascular endothelial growth factor ,Nitric oxide synthase ,chemistry.chemical_compound ,Endocrinology ,chemistry ,Physiology (medical) ,Internal medicine ,medicine ,biology.protein ,Acute pancreatitis ,Pancreatitis ,medicine.symptom ,business - Abstract
Extracellular haemoglobin (EHb) is considered a toxic molecule due to its cytotoxicity and peroxidase activity. EHb may release free hemin that increases vascular permeability, leukocyte recruitment, and adhesion molecule expression. Pancreatitis-associated ascitic fluid is reddish and may contain cell-free hemoglobin. Our aim was to determine the role of EHb in the local and systemic inflammatory response during severe acute pancreatitis in rats. To this end, taurocholate-induced necrotizing pancreatitis in rats was used. EHb levels were quantified in ascites and plasma and the hemolytic action of ascitic fluid was tested. Furthermore, we assessed if peritoneal lavage prevented the increase in EHb levels in plasma during pancreatitis. Finally, hemoglobin was purified from rat erythrocytes and administered i.p. to assess the local and systemic effects of ascitic-associated EHb during acute pancreatitis. EHb levels markedly increased in ascitic fluid and plasma during necrotizing pancreatitis. Peroxidase activity was very high in ascites. The peritoneal lavage abrogated the increase in cell-free hemoglobin in plasma. The administration of EHb enhanced ascites, dramatically increased abdominal fat necrosis, up-regulated tumor necrosis factor-a, interleukin 1ß and interleukin 6 gene expression and decreased expression of interleukin 10 in abdominal adipose tissue during pancreatitis. EHb enhanced the gene expression and protein levels of vascular endothelial growth factor (VEGF) and other hypoxia inducible factor-related genes [inducible nitric oxide synthase (inos), endothelial nitric oxide synthase (enos) and hexokinase 2] in the lung. EHb also increased myeloperoxidase activity in the lung. In conclusion, extracellular hemoglobin contributes to the inflammatory response in severe acute pancreatitis through abdominal fat necrosis and inflammation and increasing VEGF and leukocyte infiltration in the lung.
- Published
- 2014
145. Pathology handling of pancreatoduodenectomy specimens: Approaches and controversies
- Author
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Luis Sabater-Ortí, Antonio Ferrández-Izquierdo, and María del Carmen Gómez-Mateo
- Subjects
Pathology ,medicine.medical_specialty ,Pancreatic ductal adenocarcinoma ,business.industry ,Gastroenterology ,medicine.disease ,Resection ,Oncology ,Pancreatic cancer ,medicine ,Topic Highlight ,Pathology reporting ,Surgical treatment ,business ,Cancer death ,Survival rate - Abstract
Pancreatic cancer, with a 5% 5-year survival rate, is the fourth leading cause of cancer death in Western countries. Unfortunately, only 20% of all patients benefit from surgical treatment. The need to prolong survival has prompted pathologists to develop improved protocols to evaluate pancreatic specimens and their surgical margins. Hopefully, the new protocols will provide clinicians with more powerful prognostic indicators and accurate information to guide their therapeutic decisions. Despite the availability of several guidelines for the handling and pathology reporting of duodenopancreatectomy specimens and their continual updating by expert pathologists, there is no consensus on basic issues such as surgical margins or the definition of incomplete excision (R1) of pancreatic ductal adenocarcinoma. This article reviews the problems and controversies that dealing with duodenopancreatectomy specimens pose to pathologists, the various terms used to define resection margins or infiltration, and reports. After reviewing the literature, including previous guidelines and based on our own experience, we present our protocol for the pathology handling of duodenopancreatectomy specimens.
- Published
- 2014
146. Considerations on pancreatic exocrine function after pancreaticoduodenectomy
- Author
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Jaime Pérez-Griera, Luis Sabater-Ortí, Elena Muñoz-Forner, Francisco José Morera-Ocon, and Joaquín Ortega-Serrano
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Pancreatic leak ,Gastroenterology ,medicine.disease ,Pancreaticoduodenectomy ,Fat malabsorption ,Resection ,Surgery ,Oncology ,Pancreatic fistula ,Internal medicine ,medicine ,Endocrine system ,Topic Highlight ,Patient compliance ,business ,Pancreatic enzymes - Abstract
The pancreaticoduodenectomy (PD) procedure may lead to pancreatic exocrine and endocrine insufficiency. There are several types of reconstruction for this kind of operation. Pancreaticogastrostomy (PG) was introduced to reduce the rate of postoperative pancreatic fistula. Although some randomized control trials have shown no differences regarding pancreatic leakage between PG and pancreaticojejunostomy (PJ), recently some reports reveal benefits from the PG over the PJ. Some surgeons concern about the performing of the PG and inactivation of pancreatic enzymes being in contact with the gastric juice, and the detrimental results over the exocrine pancreatic function. The pancreatic exocrine function can be measured with direct and indirect tests. Direct tests have the highest sensitivity and specificity for detection of exocrine insufficiency but require tube placement. Among the tubeless indirect tests, the van de Kamer stool fat analysis remains the standard to diagnose fat malabsorption. The patient compliance and time consuming makes it not so suitable for its clinical use. Fecal immunoreactive elastase test is employed for screening of exocrine insufficiency, is not cumbersome, and has been used to study pancreatic function after resection. We analyze the FE1 levels in our patients after the PD with two types of reconstruction, PG and PJ, and we discuss some considerations about the pancreaticointestinal drainage method after pancreaticoduodenectomy.
- Published
- 2014
147. Multiple idiopathic small bowel strictures: report of three cases
- Author
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Luis Sabater, Eduardo García-Granero, Salvador Lledó, Mónica Millán, and F. Miró
- Subjects
Adult ,Male ,medicine.medical_specialty ,Fatal outcome ,business.industry ,Mechanism (biology) ,Radiography ,fungi ,Gastroenterology ,MEDLINE ,food and beverages ,Constriction, Pathologic ,Middle Aged ,Fatal Outcome ,Recurrence ,Intestine, Small ,Medicine ,Humans ,Surgery ,Female ,Radiology ,business ,Photoplethysmography - Abstract
Multiple strictures of the small bowel are relatively rare. In many cases, a distinct cause can be defined, but some strictures are unexplainable by any specific mechanism and have been termed ’idiopathic’ small bowel strictures. We present 3 cases of multiple small bowel strictures in which the affected segments were studied with perioperative photoplethysmography, in vivo specimen angiography and pathology. Neither photoplethysmographic alterations nor structural vascular lesions were found.
- Published
- 2001
148. Tc-99m sestamibi planar and SPECT imaging of a retrotracheal parathyroid adenoma
- Author
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R Herranz, Luis Sabater, Sergi Vidal-Sicart, David Fuster, Vicens Torregrosa, and Francesca Pons
- Subjects
Adenoma ,Male ,Technetium Tc 99m Sestamibi ,medicine.medical_specialty ,Scintigraphy ,Technetium (99mTc) sestamibi ,Lesion ,Retrotracheal ,Spect imaging ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Parathyroid adenoma ,Tomography, Emission-Computed, Single-Photon ,medicine.diagnostic_test ,business.industry ,Mediastinum ,General Medicine ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Parathyroid Neoplasms ,Radiology ,medicine.symptom ,Radiopharmaceuticals ,business ,Nuclear medicine ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug - Abstract
A patient with chronically increased hypercalcemia had a chest X-ray that demonstrated an enlarged mass in the upper mediastinum. Cervicothoracic CT was performed to determine the origin of this mass, but was inconclusive. The patient underwent parathyroid Tc-99m sestamibi scintigraphy which showed a large mass with increased uptake and a photopenic area inside, suggesting a parathyroid lesion. After surgery, a 30 g mass with cysts and hemorrhagic areas inside was histologically confirmed as a parathyroid adenoma.
- Published
- 1998
149. Hacia un nuevo modelo de tutor de residentes
- Author
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Luis Sabater Ortí
- Subjects
business.industry ,Medicine ,Surgery ,business ,Humanities - Published
- 2006
150. Obese rats exhibit high levels of isoprostanes in acute pancreatitis
- Author
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J Escobar, Javier Pereda, D. Royo, Juan Sastre, Luis Sabater, Salvador Pérez, Luis Aparisi, and Miguel Asensi
- Subjects
Messenger RNA ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Cell ,Alternative splicing ,Gastroenterology ,Cancer ,medicine.disease ,Gemcitabine ,medicine.anatomical_structure ,Pancreatic cancer ,RNA splicing ,medicine ,Cancer research ,Epithelial–mesenchymal transition ,business ,medicine.drug - Abstract
s / Pancreatology 12 (2012) 502–597 538 interference of Sam68 and SRSF1 expression cause a partial recovery of drug sensitivity. Conclusions: Our results show that chronic exposure of PDAC cells to gemcitabine leads to selection of a drug-resistant subpopulation overexpressing Sam68 and SRSF1. Importantly, the depletion of these proteins leads to a partial recovery of the sensibility to gemcitabine, suggesting that they may represent suitable molecular-targets to overcome drug resistance in PDAC. Arumugam T, Ramachandran V, Fournier KF, et al. Epithelial to mesenchymal transition contributes to drug resistance in pancreatic cancer. Cancer Res. 2009 Jul Shapiro IM, Cheng AW, Flytzanis NC, et al. An EMT-driven alternative splicing program occurs in human breast cancer and modulates cellular phenotype. PLoS Genet. 2011 Ghigna C, De Toledo M, Bonomi S, et al. Pro-metastatic splicing of Ron proto-oncogene mRNA can be reversed: therapeutic potential of bifunctional oligonucleotides and indole derivatives. RNA Biol. 2010 Valacca C, Bonomi S, Buratti E, et al. Sam68 regulates EMT through alternative splicing-activated nonsense-mediated mRNA decay of the SF2/ASF proto-oncogene. J Cell Biol. 2010
- Published
- 2012
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