PANCREAS
ALERTS
Gastrointest Endosc 2000;
52:183-6
Division of Gastroenterology, Washington University
School of Medicine, and the Midwest Therapeutic Endoscopy Center at BJWC, St.
Louis, Missouri, USA.
In this retrospective study based on 73 subjects, the
authors analysed the motility tracings with basal
pressure measurements of both sphincter segments considering abnormal a basal
sphincter pressure greater than 40 mm Hg in either sphincter segment. The basal
pressures in the 2 sphincter segments were highly discordant (correlation
coefficient = 0.2, p = 0.04). Basal pressures were normal in both segments in
19%, abnormal in both segments in 40%, and abnormal in 1 segment but normal in
the other in 41%. The negative predictive value of normal biliary sphincter
pressure in excluding sphincter dysfunction was 0.42; when the pancreatic
sphincter pressure was normal, the negative predictive value was 0.58. The
incidence of pancreatitis with dual duct manometry
was comparable to the institutional experience with all sphincter studies.
The authors concluded that, although the clinical
relevance of individually elevated sphincter pressures remains uncertain, there
is significant discordance of basal pressures between the biliary and
pancreatic sphincter segments. If only biliary sphincter pressure was measured,
one fourth of abnormal sphincter pressures would be missed. Therefore, if the first
sphincter segment has a normal basal pressure, the other segment should also be
evaluated.
Surgery
2000; 128:353-60
Department of Surgery, Center for Molecular and
Structural Biology, and Hollings Cancer Center, Medical University of South
Carolina, Charleston
The authors determined whether the application of CaSm antisense gene therapy would generate a significant
antitumor effect against pancreatic cancer (PC). They used an adenoviral vector
(Ad-alphaCaSm) creating a 900-base pair antisense RNA
to CaSm . The PC cell lines AsPC-1 and Capan-1 were
infected with this vector and examined for changes in in-vitro proliferation by
using methyl thiazol tetrazolium
and soft agar assays. SCID-Bg mice bearing
subcutaneous AsPC-1 tumors were treated with Ad-alphaCaSm
(1 x 10(9) plaque-forming units) using a single intratumor
injection with tumor growth and survival being monitored. AsPC-1 and Capan-1
cells showed decreased in vitro proliferation (93%, P =.0041, and 70%, P
=.0038, respectively) and anchorage independent growth (55%, P =.02, and 45%, P
=.03, respectively) after treatment. Ad-alphaCaSm
reduced in vivo AsPC-1 tumor growth by 40% (n = 10), extending median survival
time from 35 to 60 days. The authors concluded that Ad-alphaCaSm
demonstrates a significant antitumor effect against pancreatic cancer both in
vitro and in vivo.
These results support the role of CaSm
as a significant gene involved in the neoplastic transformation of pancreatic
tumors. Thus CaSm represents a novel gene target in
PC and holds potential as a new treatment approach either alone or in
combination with existing therapies.