Tomoaki Takeyama

Objective evaluation of blood flow in the small-intestinal villous: quantification of findings from dynamic endoscopy with concomitant narrow-band imaging

Background and aims  We have previously shown that the increase in blood flow volume in jejunum villi after spraying of 10 % dextrose solution correlates with pancreatic exocrine function (PEF). The aim of this study was to establish an objective method to evaluate the amount of jejunum villous blood flow using a novel image analysis system. Patients and methods  The subjects were 26 patients who underwent upper gastrointestinal endoscopy with a newly developed small intestine endoscope (SIF-Y0007, Olympus, Tokyo, Japan). By defining the ratio of capillary occupancy in each villus at levels from 1 to 5, villous blood flow was evaluated subjectively on the villous blood flow scale (VBFS). Objective evaluation was performed based on luminance analysis. The morphological opening process was used to make images with leveled brightness. A histogram was prepared from the luminance information and the standard deviation was determined and defined as SDOV (Standard Deviation calculated from a histogram made by luminance analysis Of Villi). PEF was evaluated by measuring the BT-PABA (N-benzoyl-L-tyrosyl-p-aminobenzoic acid) excretion rate. Results  There was a significant positive correlation between VBFS and SDOV ( P  < 0.0001, ρ = 0.5882). SDOV was also positively correlated with PEF ( P  = 0.0004, ρ = 0.6421). Conclusions  SDOV is a new objective index for evaluation of blood flow volume in jejunum villi. SDOV may be useful in clinical practice to estimate PEF and for clarification of the mechanisms underlying the functional correlation between the pancreas and small intestine.

Tu1891 Feasibility of Non-Invasive Method of Diagnosing Pancreatic Fibrosis Using Shear Wave Elastography

whether Hpa is involved in the pathogenesis of cerulein-induced AP in mice. Material and Methods: Heparanase over-expressing transgenic mice (hpa-TG) and their wild-type (WT) BALB/c mice, and Hpa knockout mice (hpa-KO) and their WT C57BL mice were intraperitoneally injected with either Cerulein (50 mg/kg, 5 times, at 1 hour apart) or vehicle. Pancreatic Hpa activity, edema, and inflammation along blood amylase and lipase levels, were determined 24 hours following pancreatitis induction. Results: Cerulein-induced pancreatitis in wild type mice was associated with significant rises in the serum levels of amylase and lipase. These increases were characterized by enhancement of Hpa activity and pancreatic inflammation. The elevation in amylase and lipase as well as pancreatic edema/inflammation responses to administration of cerulein were profoundly exaggerated in hpa-TG mice. In contrast, when cerulein was injected to hpa-KO mice, the severity of pancreatitis was attenuated as compared with their wild type controls. Importantly, pretreatment with Hpa inhibitor (PG545) reduced significantly the inflammatory response of acute pancreatitis by ameliorating pancreatic edema, amylase, and lipase serum levels. Conclusions: The hpa-TG mice are more susceptible to acute pancreatitis than their WT controls, indicating a role for Hpa in the pathogenesis of this disease state. The pancreatic-protective effects of Hpa inhibition provide a rational basis for therapeutic application of Hpa inhibitors.

Tu1950 Psychological Distress and Its Impact on the Survival in Patients With Pancreatic Cancer: A Prospective Analysis

Purpose : Porphyrin-based photosensitizers are most commonly used in photodynamic therapy (PDT). However, these drugs are exported extracellularly by a cell-mambrane transporter, the ATP-binding cassette subfamily G member 2 (ABCG2), which decreases the PDTinduced cytotoxicity in cancer treatment. Pegylation of a drug increases its molecular size. We hypothesized that intracellular level of a porphyrin can be increased by its pegylated form, which enhance the PDT-induced cytotoxicity. Our aim of study was to examine the escaping of ABCG2 function in the PDT using pegylated-Chlorin E6 (Che6) in the pancreatic cancer cells. Methods : We pegylated Che6 using a methoxy polyethylene glycol and branched polyethylenimine. AsPC-1 and MiaPaCa-2 cells were selected, which showed the low and high ABCG2 expression level, respectively. Intracellular level of Che6 and pegylatedChe6 was detected by Fluorescence meter, FACS and confocal microscope. Cells were incubated with 0.1 10 μM of Che6 and pegylated-Che6. They were exposed to a diode laser emitting at 670 nm wave length with total radiation dose of 6 J/cm2. Cell viability was determined by MTT assay. Production level of singlet oxygen was detected with photomultiplier-tube based singlet oxygen detection system. An antitumor PDT effects in AsPC-1 cellbearing BALC/nude mice of the Che6 and pegylated-Che6 were investigated. Results : The

Tu1489 Correlation Between Pancreatic Exocrine Function and Small-Intestinal Villus Form in Patients With Different Kind of Pancreatic Disorders

Baseline characteristics of the two study populations are shown in table 1. There was no difference in cold ischemia time in those with a greater than 50% drop in c-peptide compared with those without a 50% decrease (966 vs. 963 minutes, p=0.35). There was no difference between groups (> 50% decreased group vs. no > 50% decrease group) in terms of isolated islet equivalents per /kilogram body weight (5752 vs. 3687, p=0.16), 6 month insulin requirements (10 U vs. 5 U, p=0.33), or 6 month HgA1c levels (6.6 vs 6.1 mmol/L, p= 0.29). Odds ratios calculated for age, gender, body mass index, surgery type or the number of isolated islet equivalents were not significant for predicting islet cell function. CONCLUSION: Cold ischemia time is not a predictor of successful islet engraftment in patients undergoing pancreatectomy with remote islet isolation. These findings lend support to remote islet isolation as an acceptable technique for islet autotransplant. Baseline Characteristics of Patients Based on 6 Month C-peptide Level