No abstract available.

Pancreatic cancer is still one of the most devastating cancers with less than 5% of 5-year survival even though the advances in modern medicine. Considering effective screening strategies and vaccinations has been improving clinical outcomes in other gastrointestinal malignancies, there is not yet effective tools for pancreatic cancer in earlier stage. Thus, about 80% of patients of pancreatic cancer are diagnosed as unsuitable for curative resection. Furthermore, recent experimental data suggest metastasis of pancreatic cancer can be developed in remarkably earlier stage during carcinogenesis. Based on these findings, systemic chemotherapy is the main therapeutic option for treating pancreatic cancer. However, the outcome of systemic chemotherapy is still disappointing even though recent data with FOLFIRINOX and nab-paclitaxel showed relatively promising. With advances in molecular technologies including next generation sequencing, the therapeutic paradigm for handling malignancies has been rapidly changing. The new wave of tailored or precision medicine leads to develop several novel therapeutic options like immune check point inhibitor or novel adoptive cell therapy. Herein, we will discuss the current status and perspectives of targeted therapy for pancreatic cancer.
Carcinogenesis ; Cell- and Tissue-Based Therapy ; Drug Therapy ; History, Modern 1601- ; Humans ; Mass Screening ; Neoplasm Metastasis ; Pancreatic Neoplasms* ; Precision Medicine ; Vaccination

Pancreatic cancer is still one of the most devastating cancers with less than 5% of 5-year survival even though the advances in modern medicine. Considering effective screening strategies and vaccinations has been improving clinical outcomes in other gastrointestinal malignancies, there is not yet effective tools for pancreatic cancer in earlier stage. Thus, about 80% of patients of pancreatic cancer are diagnosed as unsuitable for curative resection. Furthermore, recent experimental data suggest metastasis of pancreatic cancer can be developed in remarkably earlier stage during carcinogenesis. Based on these findings, systemic chemotherapy is the main therapeutic option for treating pancreatic cancer. However, the outcome of systemic chemotherapy is still disappointing even though recent data with FOLFIRINOX and nab-paclitaxel showed relatively promising. With advances in molecular technologies including next generation sequencing, the therapeutic paradigm for handling malignancies has been rapidly changing. The new wave of tailored or precision medicine leads to develop several novel therapeutic options like immune check point inhibitor or novel adoptive cell therapy. Herein, we will discuss the current status and perspectives of targeted therapy for pancreatic cancer.
Carcinogenesis ; Cell- and Tissue-Based Therapy ; Drug Therapy ; History, Modern 1601- ; Humans ; Mass Screening ; Neoplasm Metastasis ; Pancreatic Neoplasms* ; Precision Medicine ; Vaccination

The polypoid lesions of gallbladder have explosively increased with enhanced feasibility of transabdominal ultrasonography. Most of small polyps less than 10 mm are benign and remain static for a long period. In small polyps, three to six month intervaled ultrasonography is warranted in the initial follow-up, but the duration of follow-up period is not clarified. The polypoid lesions larger than 10 mm show a quite different feature. They showed a remarkable risk of malignancy (34-88%) and should be treated by surgery. Furthermore, age more than 50 years and combined gallstone are important factors predicting malignancy in polypoid lesions of gallbladder. In addition, other factors including solitary polyp and the presence of symptoms are considered as risk factors. Laparoscopic cholecystectomy is a golden standard therapy for these polyps unless the suspicion of malignancy is high. The gallbladder polyps remain a problem of concern to both doctors and patient with the worry of malignancy. Thus, the comprehensive understanding of natural coruse of gallbladder polyp and risk factors of malignancy should be kept in mind.
Cholecystectomy, Laparoscopic ; Gallbladder Diseases/classification/*pathology/surgery ; Gallbladder Neoplasms/diagnosis ; Humans ; Polyps/classification/*pathology/surgery ; Risk Factors

Pancreatic cancer is still one of the most aggressive malignancy, showing 10% of 5-year survival. Among the several reasons of the grave prognosis, the poor response to chemotherapeutic agents and the absence of effective tool for early detection are the most important. Regarding treatments, surgical resection is still positioned as the only one for expecting the cure of pancreatic cancer. However, the rate of recurrence after surgery is still high as more than 50%. And the portion of patients who are diagnosed at the resectable stage is still less than 15% of all cases. So, chemotherapy and radiotherapy are the main players for combating with pancreatic cancer. After the introduction of outcomes of FOLFIRINOX, and gemcitabineabpaclitaxel for metastatic pancreatic cancer, two-digit overall survival can be expected. And, neoadjuvant treatments including concurrent chemoradiation therapy for borderline resectable pancreatic cancer and/or resectable pancreatic cancer are reported as superior to upfront surgery. More recently, several target agents including polyadenosine diphosphate-ribose polymerase inhibitors and immunologic drugs are under evaluation for pancreatic cancer. So, herein, current status of chemotherapy and radiation therapy for pancreatic cancer will be addressed.

Pancreatic cancer is still one of the most dreadful malignancies with 5-year survival of 5%. The lack of effective diagnostic tools for early detection of pancreatic cancer is the major factor for the poor prognosis of pancreatic cancer. Considering the relatively lower incidence of pancreatic cancer, it seems to be reasonable to find and investigate the high risk group of pancreatic cancer rather than to screen general population. During the last 2 decades, several epidemiologic and genetic high risk groups of pancreatic cancer were found. Especially, western countries including US have been taking care of genetic high risk group and reported several meaningful outcomes. With advances of understanding molecular carcinogenesis and progression of pancreatic cancer, the effort to find specific biomarkers for both detection and treatment of pancreatic cancer has been overwhelmed. Various types of biomarkers including protein, microRNA, exosomes or circulating tumor cells itself have been under investigations. Although there has been no single biomarker which can overcome CA19-9 in serum to date. It will be worthwhile to wait for more potent biomarker which can be used for early diagnosis and treatment of pancreatic cancer in near future.
Biomarkers ; Carcinogenesis ; Early Diagnosis* ; Exosomes ; Incidence ; MicroRNAs ; Neoplastic Cells, Circulating ; Pancreatic Neoplasms* ; Prognosis

Acute pancreatitis is an inflammatory disease that is caused by various etiologies including gallstone, alcohol or hypertriglyceridemia. Although most cases of acute pancreatitis show self-limiting course, severe cases are still associated with significant morbidity and mortality. The pathogenic mechanisms of acute pancreatitis are not fully understood. However, it is a central dogma that premature intracellular activation of trypsinogen is the earliest pathologic event. Even though it remains unknown how intracellular trypsinogen activation can be caused by such diverse etiologies, this initial insult in pancreatic acinar cells lead to local inflammatory complications and a systemic response or death. Pathophysiologic mechanisms related to the progression of acute pancreatitis include microcirculatory injury, chemoattraction of inflammatory cells, release of pro-inflammatory cytokines, and bacterial translocation to pancreas and systemic circulation. Recently, several interesting transgenic mice model experiments shed a light in trypsin independent mechanism of local and systemic inflammation for progression of acute pancreatitis.
Acinar Cells ; Animals ; Bacterial Translocation ; Cytokines ; Gallstones ; Hypertriglyceridemia ; Inflammation ; Light ; Mice ; Mice, Transgenic ; Pancreas ; Pancreatitis ; Trypsin ; Trypsinogen

[6]-Gingerol, a major phenolic compound derived from ginger, has anti-bacterial, anti-inflammatory and anti-tumor activities. While several molecular mechanisms have been described to underlie its effects on cells in vitro and in vivo, the underlying mechanisms by which [6]-gingerol exerts anti-tumorigenic effects are largely unknown. The purpose of this study was to investigate the action of [6]-gingerol on two human pancreatic cancer cell lines, HPAC expressing wild- type (wt) p53 and BxPC-3 expressing mutated p53. We found that [6]-gingerol inhibited the cell growth through cell cycle arrest at G1 phase in both cell lines. Western blot analyses indicated that [6]-gingerol decreased both Cyclin A and Cyclin-dependent kinase (Cdk) expression. These events led to reduction in Rb phosphorylation followed by blocking of S phase entry. p53 expression was decreased by [6]-gingerol treatment in both cell lines suggesting that the induction of Cyclin-dependent kinase inhibitor, p21(cip1), was p53-independent. [6]-Gingerol induced mostly apoptotic death in the mutant p53-expressing cells, while no signs of early apoptosis were detected in wild type p53-expressing cells and this was related to the increased phosphorylation of AKT. These results suggest that [6]-gingerol can circumvent the resistance of mutant p53- expressing cells towards chemotherapy by inducing apoptotic cell death while it exerts cytostatic effect on wild type p53- expressing cells by inducing temporal growth arrest.
Tumor Suppressor Protein p53/*genetics/metabolism ; Proto-Oncogene Proteins c-akt/genetics/metabolism ; Pancreatic Neoplasms/*drug therapy ; Mutation ; Humans ; Gene Expression Regulation, Neoplastic/drug effects ; Fatty Alcohols/*pharmacology/therapeutic use ; Drug Resistance, Neoplasm ; Cell Proliferation/drug effects ; Cell Line, Tumor ; Cell Cycle/*drug effects ; Apoptosis/*drug effects ; Antineoplastic Agents/*pharmacology/therapeutic use

Advanced Hodgkin's disease is usually treated with six or more cycles of combination chemotherapy. Spontaneous regression of the cancer is very rarely reported in patients with Hodgkin's disease. We present an unusual case of a patient with Hodgkin's disease who experienced complete remission with a single cycle of chemotherapy, followed by pneumonia. The case was a 36-year-old man diagnosed with stage IVB mixed cellularity Hodgkin's disease in November 2000. After treatment with one cycle of COPP-ABV (cyclophosphamide, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, and vinblastine) chemotherapy without bleomycin, the patient developed interstitial pneumonia and was cared in the intensive care unit (ICU) for two months. Follow-up chest computerized tomography (CT), performed during the course of ICU care, revealed markedly improved mediastinal lymphomatous lesions. Furthermore, follow-up whole body CT and 18-fluorodeoxyglucose positron emission tomography showed complete disappearance of the lymphomatous lesions. Four years later, the patient is well and without relapse. This report is followed by a short review of the literature on spontaneous regression of Hodgkin's disease. To the best of our knowledge, this is the first case report of spontaneous remission of Hodgkin's disease in Korea.
Adult ; Antineoplastic Combined Chemotherapy Protocols/*administration & dosage ; Bleomycin/*administration & dosage ; Cyclophosphamide/*administration & dosage ; Doxorubicin/*administration & dosage ; Hodgkin Disease/*complications/*drug therapy ; Humans ; Male ; Pneumonia/*complications ; Prednisone/*administration & dosage ; Procarbazine/*administration & dosage ; Remission, Spontaneous ; Vinblastine/*administration & dosage ; Vincristine/*administration & dosage

Tumors of the major duodenal papilla, also known as ampullary tumor, are rare with an approximate 5% incidence of all gastrointestinal neoplasm. These tumors seem to be detected more frequently with increasing performance of upper endoscopic examination and endoscopic retrograde cholangiopancreatography (ERCP). Adenoma, most common benign disease of ampullary tumor, is very important because of its potential to undergo malignant transformation to ampullary cancer. Especially, endoscopic ultrasound or transpapillary intraductal ultrasonography can provide more detailed and accurate information on the extent of ampullary tumors and proper treatment should be done after diagnosis. Considering perioperative morbidity and mortality of surgical resection, endoscopic papillectomy is regarded as a curative treatment of ampullary adenoma. However, the indication of the procedure is very strict and there are various complications related to the procedure. Therefore, it is important to understand the role of endoscopy in diagnosis and treatment of ampullary tumor. In this review, the diagnostic role of endoscopy for ampullary tumor and the treatment method of endoscopic papillectomy will be discussed.
Adenoma ; Ampulla of Vater ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Endoscopy* ; Gastrointestinal Neoplasms ; Incidence ; Mortality ; Ultrasonography