While long-standing diabetes is a risk factor of pancreatic cancer, new-onset diabetes could be a consequence of underlying pancreatic malignancy. About 30% to 50% of pancreatic cancer patients have new-onset diabetes. Because diabetes develops in preclinical or early stages of pancreatic cancer, it could serve as an excellent clue for early detection of pancreatic cancer. Insulin resistance associated with hyperglycemia and hyperinsulinemia by diabetogenic factors secreted from cancer cells have been suggested to be a possible mechanism of pancreatic cancer-induced diabetes. It is difficult to differentiate pancreatic cancer-induced diabetes from the more common type 2 diabetes. Although several clinical features and potential biomarkers have been investigated, optimal strategies and modalities to screen pancreatic cancer among the new-onset diabetes have not yet been fully determined.
Adiponectin/metabolism ; Age Factors ; Body Mass Index ; Cytokines/metabolism ; Diabetes Mellitus, Type 2/*complications/*diagnosis/pathology ; Humans ; Pancreatic Neoplasms/*complications/*diagnosis/pathology ; Tomography, X-Ray Computed

Sweet's syndrome is a neutrophilic dermatoses characterized by the abrupt onset of fever, leukocytosis and skin lesions that are infiltrated by neutrophils. Most skin lesions are in the form of erythematous tender papules or nodules, usually affecting the upper limbs, face or neck and histologically a dense perivascular infiltrate of neutrophils without vasculitis. Sweet's syndrome can be associated with several disorders, such as inflammatory bowel disease, malignant tumors, and autoimmune diseases including rheumatoid arthritis. We report a case of Sweet's syndrome with associated rheumatoid arthritis. The patient had multiple skin lesions in her face, neck, both upper and lower extremities except trunk, and complained fever, chills and arthralgia. The result of skin biopsy showed mature neutriphil infiltration and leukocytoclasia of dermis without vasculitis, which was compatible with Sweet's syndrome.
Arthralgia ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Biopsy ; Chills ; Dermis ; Fever ; Humans ; Inflammatory Bowel Diseases ; Leukocytosis ; Lower Extremity ; Neck ; Neutrophils ; Skin ; Skin Diseases ; Sweet Syndrome ; Upper Extremity ; Vasculitis

Behcet'sdisease is a chronic inflammatory disease characterized by oral ulcers, genital ulcers, uveitis, and skin lesions. Furthermore, Behcet's disease can manifest as vascular lesions, such as, those of vasculitis, venous thrombosis, or thrombophlebitis or as an arterial aneurysm. Here, the authors report the case of a pulmonary artery aneurysm and deep vein thrombosis in a 41-year-old woman with a previous diagnosis of Behcet's disease. The patient presented with hemoptysis and a cough, and was found to have a bleeding pulmonary artery aneurysm at the right lower lung. Pulmonary arteriography was performed and the aneurysm was embolized with coils. As a result, hemoptysis did not subsequently recur. However, five years later, deep vein thrombosis occurred in the left leg. Left leg pain improved after the regional infusion of thrombolytics.
Aneurysm ; Angiography ; Cough ; Female ; Hemoptysis ; Hemorrhage ; Humans ; Leg ; Lung ; Oral Ulcer ; Pulmonary Artery ; Skin ; Thrombophlebitis ; Ulcer ; Uveitis ; Vasculitis ; Venous Thrombosis

Behcet'sdisease is a chronic inflammatory disease characterized by oral ulcers, genital ulcers, uveitis, and skin lesions. Furthermore, Behcet's disease can manifest as vascular lesions, such as, those of vasculitis, venous thrombosis, or thrombophlebitis or as an arterial aneurysm. Here, the authors report the case of a pulmonary artery aneurysm and deep vein thrombosis in a 41-year-old woman with a previous diagnosis of Behcet's disease. The patient presented with hemoptysis and a cough, and was found to have a bleeding pulmonary artery aneurysm at the right lower lung. Pulmonary arteriography was performed and the aneurysm was embolized with coils. As a result, hemoptysis did not subsequently recur. However, five years later, deep vein thrombosis occurred in the left leg. Left leg pain improved after the regional infusion of thrombolytics.
Aneurysm ; Angiography ; Cough ; Female ; Hemoptysis ; Hemorrhage ; Humans ; Leg ; Lung ; Oral Ulcer ; Pulmonary Artery ; Skin ; Thrombophlebitis ; Ulcer ; Uveitis ; Vasculitis ; Venous Thrombosis

BACKGROUND/AIMS: Radiofrequency ablation (RFA) is one of the most frequently applied curative treatments in patients with a single small hepatocellular carcinoma (HCC). However, the clinical significance of and risk factors for early massive recurrence after RFA—a dreadful event limiting further curative treatment—have not been fully evaluated. METHODS: In total, 438 patients with a single HCC of size ≤3 cm who underwent percutaneous RFA as an initial treatment between 2006 and 2009 were included. Baseline patient characteristics, overall survival, predictive factors, and recurrence after RFA were evaluated. In addition, the incidence, impact on survival, and predictive factors of early massive recurrence, and initial recurrence beyond the Milan criteria within 2 years were also investigated. RESULTS: During the median follow-up of 68.4 months, recurrent HCC was confirmed in 302 (68.9%) patients, with early massive recurrence in 27 patients (6.2%). The 1-, 3-, and 5-year overall survival rates were 95.4%, 84.7%, and 81.8%, respectively, in patients with no recurrence, 99.6%, 86.4%, and 70.1% in patients with recurrence within the Milan criteria or late recurrence, and 92.6%, 46.5%, and 0.05% in patients with early massive recurrence. Multivariable analysis identified older age, Child-Pugh score B or C, and early massive recurrence as predictive of poor overall survival. A tumor size of ≥2 cm and tumor location adjacent to the colon were independent risk factors predictive of early massive recurrence. CONCLUSIONS: Early massive recurrence is independently predictive of poor overall survival after RFA in patients with a single small HCC. Tumors sized ≥2 cm and located adjacent to the colon appear to be independent risk factors for early massive recurrence.
Aged ; Carcinoma, Hepatocellular/mortality/pathology/*surgery ; Catheter Ablation ; Female ; Hepatitis B/complications ; Hepatitis C/complications ; Humans ; Liver Neoplasms/mortality/pathology/*surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome

A biosynthetic gene cluster for the bioactive fungal sesterterpenoids variecolin ( 1) and variecolactone ( 2) was identified in Aspergillus aculeatus ATCC 16872. Heterologous production of 1 and 2 was achieved in Aspergillus oryzae by expressing the sesterterpene synthase VrcA and the cytochrome P450 VrcB. Intriguingly, the replacement of VrcB with homologous P450s from other fungal terpenoid pathways yielded three new variecolin analogues ( 5- 7). Analysis of the compounds' anticancer activity in vitro and in vivo revealed that although 5 and 1 had comparable activities, 5 was associated with significantly reduced toxic side effects in cancer-bearing mice, indicating its potentially broader therapeutic window. Our study describes the first tests of variecolin and its analogues in animals and demonstrates the utility of synthetic biology for creating molecules with improved biological activities.